MCMI-III™
Millon™ Clinical Multiaxial Inventory-III
Interpretive Report
Theodore Millon, PhD, DSc
Name:Ann (pseudonym)
ID Number:
Age:37
Gender:Female
Setting:Unknown
Date Assessed:01/16/2006 (false date)
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MCMI-III™ Interpretive Report01/16/2006, Page 2
CAPSULE SUMMARY
MCMI-III reports are normed on patients who were in the early phases of assessment or psychotherapy for emotional discomfort or social difficulties. Respondents who do not fit this normative population or who have inappropriately taken the MCMI-III for nonclinical purposes may have inaccurate reports. The MCMI-III report cannot be considered definitive. It should be evaluated in conjunction with additional clinical data. The report should be evaluated by a mental health clinician trained in the use of psychological tests. The report should not be shown to patients or their relatives.
Interpretive Considerations
The client is a 37-year-old female. She did not identify specific problems and difficulties of an Axis I nature in the demographic portion of this test.
Unless this patient is a well-functioning adult with only minor life stressors, her responses suggest a need for social approval or naivete about psychological matters. This interpretive report should be read with these characteristics in mind.
Profile Severity
On the basis of the test data (assuming denial is not present), it may be reasonable to assume that the patient is exhibiting psychological dysfunction of mild to moderate severity. The text of the following interpretive report may need to be modulated slightly downward given this probable level of severity.
Possible Diagnoses
She appears to fit the following Axis II classifications best: Dependent Personality Traits, Histrionic Personality Features, and Negativistic (Passive-Aggressive) Personality Features.
Axis I clinical syndromes are suggested by the client's MCMI-III profile in the area of Generalized Anxiety Disorder.
Therapeutic Considerations
Cooperative, amiable, and often overtly conforming, this patient typically avoids disturbing thoughts and troublesome responsibilities. She may be unwilling to take psychological discomfort seriously. Although she is cooperative in situations that call for limited responsibility, she may be reluctant to assume a full share of responsibility. Claims of helplessness should be recognized but not acceded to. A distinct, supportive approach within the framework of a circumscribed or time-limited treatment model should prove quite helpful.
MCMI-III™ Interpretive Report01/16/2006, Page 3
MILLON CLINICAL MULTIAXIAL INVENTORY - III
CONFIDENTIAL INFORMATION FOR PROFESSIONAL USE ONLY
INVALIDITY (SCALE V) = 0 / INCONSISTENCY (SCALE W) = 4PERSONALITY CODE: / - ** 3 * 4 8A 6B 6A + 2B 7 5 8B 2A " 1 ' ' // - ** - * //
SYNDROME CODE: / - ** A * // - ** - * //
DEMOGRAPHIC CODE: / 94998/-/F/37/-/-/-/--/--/------/--/------/
CATEGORY / SCORE / PROFILE OF BR SCORES / DIAGNOSTIC SCALES
RAW / BR / 0 / 60 / 75 / 85 / 115
84 / 51 / DISCLOSURE
X
MODIFYING / Y / 17 / 75 / DESIRABILITY
INDICES
Z / 7 / 47 / DEBASEMENT
1 / 1 / 12 / SCHIZOID
2A / 3 / 35 / AVOIDANT
2B / 6 / 59 / DEPRESSIVE
3 / 12 / 83 / DEPENDENT
CLINICAL / 4 / 18 / 66 / HISTRIONIC
PERSONALITY / 5 / 11 / 52 / NARCISSISTIC
PATTERNS
6A / 5 / 60 / ANTISOCIAL
6B / 6 / 62 / SADISTIC
7
16 / 57 / COMPULSIVE
8A / 8 / 64 / NEGATIVISTIC
8B / 2 / 39 / MASOCHISTIC
SEVERE / S / 2 / 39 / SCHIZOTYPAL
PERSONALITY / C / 4 / 47 / BORDERLINE
PATHOLOGY / P
5 / 61 / PARANOID
A / 4 / 75 / ANXIETY
H / 1 / 15 / SOMATOFORM
N / 2 / 24 / BIPOLAR: MANIC
CLINICAL / D
2 / 24 / DYSTHYMIA
SYNDROMES
B / 3 / 60 / ALCOHOL DEPENDENCE
T / 0 / 0 / DRUG DEPENDENCE
R / 2 / 30 / POST-TRAUMATIC STRESS
SEVERE / SS / 9 / 68 / THOUGHT DISORDER
CLINICAL / CC / 1 / 15 / MAJOR DEPRESSION
SYNDROMES / PP / 0 / 0 / DELUSIONAL DISORDER
MCMI-III™ Interpretive Report
01/16/2006, Page 4
RESPONSE TENDENCIES
Unless this patient is a demonstrably well-functioning adult who is currently facing minor life stressors, her responses suggest (1) a well-established need for social approval and commendation, evident in tendencies to present herself in a favorable light, or (2) a general naivete about psychological matters, including a possible deficit in self-knowledge. The interpretation of this profile should be made with these characteristics in mind.
The BR scores reported for this individual have been modified to account for the psychic tension indicated by the elevation on Scale A (Anxiety).
AXIS II: PERSONALITY PATTERNS
The following paragraphs refer to those enduring and pervasive personality traits that underlie this woman's emotional, cognitive, and interpersonal difficulties. Rather than focus on the largely transitory symptoms that make up Axis I clinical syndromes, this section concentrates on her more habitual and maladaptive methods of relating, behaving, thinking, and feeling.
The MCMI-III profile of this woman may be characterized on the surface by submissiveness, dependency, and the seeking of affection, attention, and security. A fear of abandonment often compels her to be overly compliant and obliging. She may be quite naive about interpersonal matters, and she may evince scattered and immature thinking. When faced with interpersonal tensions, she seeks instant signs of reassurance or tries to maintain an air of Pollyanna buoyancy, thereby denying disturbing emotions and discomfort. Uncomfortable when alone and preoccupied with the fear of being abandoned, she is likely to be exceedingly responsive to the desires of others. Having learned to play an inferior role, she allows others to feel more useful, stronger, and more competent than she. An active soliciting of praise and a tendency to be self-sacrificing and conciliatory are apparent. She persistently seeks harmony with others, even at the expense of her own values and beliefs. Although she avoids situations that involve personal conflict, her efforts at control give way at times, and her resentment and frustration over her acquiescence and self-denial break into the open.
Beneath her surface characteristics lie a repressed anger and irritability that derive from an awareness that she has no identity apart from others. She has learned to value the intrinsic traits of those who are important to her, not her own. Despite her need to ally herself with the competencies of others, she is no longer bolstered by the illusion that these relationships fulfill her needs or protect her against loss. Despite her growing disillusionment with others, she remains alert to signs of potential hostility and rejection and seeks to minimize the danger associated with the disapproval or indifference of others. She has learned that by closely attending to the signals and desires of others, she can shape her behavior to conform to their wishes and needs.
Although she has a growing desire for more independence, she feels helpless when faced with responsibilities that demand autonomy or initiative. The loss of a significant source of support or identification may prompt acute distress and may compel her to openly solicit signs of reassurance. Periodic manifestations of illness, anxiety, and depression may be displayed instrumentally to deflect serious criticism and to transform threats of disapproval into those of support and sympathy. More extreme reactions may emerge when her security is genuinely threatened.
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The clinician should note that this woman may not admit on a test to weaknesses or emotional difficulties; as a result, there may have been considerable denial of psychological symptomatology. The need to convey the impression that "all is well" may decrease the likelihood that various Axis I disorders have been diagnosed on the MCMI-III.
AXIS I: CLINICAL SYNDROMES
The features and dynamics of the following Axis I clinical syndromes appear worthy of description and analysis. They may arise in response to external precipitants but are likely to reflect and accentuate several of the more enduring and pervasive aspects of this woman's basic personality makeup.
This woman feels atypically apprehensive, and a number of responses on the MCMI-III suggest that she is experiencing a generalized anxiety disorder. Physical symptoms such as fatigue and insomnia may be present, as well as a variety of behavioral indices (e.g., she may be ill-at-ease and high-strung). She needs stimulation and activity, and her current anxieties may stem from being "at loose ends," feeling empty, finding herself stranded with no one to lean on or nothing to anticipate. Another possibility is that she is dramatizing her current distress to gain attention.
NOTEWORTHY RESPONSES
The client answered the following statements in the direction noted in parentheses. These items suggest specific problem areas that the clinician may wish to investigate.
Health Preoccupation
No items endorsed.
Interpersonal Alienation
No items endorsed.
Emotional Dyscontrol
14. Sometimes I can be pretty rough and mean in my relations with my family. (True) 22. I'm a very erratic person, changing my mind and feelings all the time. (True)
34. Lately, I have gone all to pieces. (True)
87. I often get angry with people who do things slowly. (True)
Self-Destructive Potential
No items endorsed.
Childhood Abuse
No items endorsed.
Eating Disorder
No items endorsed.
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POSSIBLE DSM-IV® MULTIAXIAL DIAGNOSES
The following diagnostic assignments should be considered judgments of personality and clinical prototypes that correspond conceptually to formal diagnostic categories. The diagnostic criteria and items used in the MCMI-III differ somewhat from those in the DSM-IV, but there are sufficient parallels in the MCMI-III items to recommend consideration of the following assignments. It should be noted that several DSM-IV Axis I syndromes are not assessed in the MCMI-III. Definitive diagnoses must draw on biographical, observational, and interview data in addition to self-report inventories such as the MCMI-III.
Axis I: Clinical Syndrome
The major complaints and behaviors of the patient parallel the following Axis I diagnoses, listed in order of their clinical significance and salience.
300.02 Generalized Anxiety Disorder
Axis II: Personality Disorders
Deeply ingrained and pervasive patterns of maladaptive functioning underlie Axis I clinical syndromal pictures. The following personality prototypes correspond to the most probable DSM-IV diagnoses (Disorders, Traits, Features) that characterize this patient.
Personality configuration composed of the following:
Dependent Personality Traits
Histrionic Personality Features
and Negativistic (Passive-Aggressive) Personality Features
Course: The major personality features described previously reflect long-term or chronic traits that are likely to have persisted for several years prior to the present assessment.
The clinical syndromes described previously tend to be relatively transient, waxing and waning in their prominence and intensity depending on the presence of environmental stress.
Axis IV: Psychosocial and Environmental Problems
In completing the MCMI-III, this individual identified the following problems that may be complicating or exacerbating her present emotional state. They are listed in order of importance as indicated by the client. This information should be viewed as a guide for further investigation by the clinician.
None Identified
TREATMENT GUIDE
If additional clinical data are supportive of the MCMI-III's hypotheses, it is likely that this patient's difficulties can be managed with either brief or extended therapeutic methods. The following guide to treatment planning is oriented toward issues and techniques of a short-term character, focusing on matters that might call for immediate attention, followed by time-limited procedures designed to reduce the likelihood of repeated relapses. Once this patient's more pressing or acute difficulties are adequately
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stabilized, attention should be directed toward goals that would aid in preventing a recurrence of problems, focusing on circumscribed issues and employing delimited methods such as those discussed in the following paragraphs.
To achieve significant goals employing short-term methods, environmental changes should be introduced early to maximize the patient's growth and to minimize her continued dependency. Psychopharmacologic treatment, notably certain antidepressants and anti-anxiety agents, may be useful in increasing the patient's confidence and vigor, for she may be inclined to postpone efforts at changing her assumptions and acquiring a measure of independence. Interpersonal techniques may be used in the therapeutic relationship to assure that the dominance-submission pattern that has characterized the patient's history is not reactivated. Cognitively nondirective and humanistic approaches are highly likely to foster the growth of autonomy in a short-term regimen.
Although this patient may have been disinclined to share intimate feelings on an impersonal self-report inventory, she will probably unburden herself to the therapist under a treatment regimen that is strong in empathic caring. She may not show a high degree of insight into her difficulties, but she will be quite receptive to cognitive reframing techniques (e.g., Beck, Ellis) and to various interpersonal methods (e.g., Benjamin, Klerman). Because she is disposed to trust others, she may invest great powers and the highest of virtue in the therapist, both of which should facilitate progress in brief short-term procedures.
As noted, this woman may welcome the opportunity to depend on the strength, authority, and helpfulness of the therapist. This auspicious beginning is most fortunate, but it may give a misleading impression of significant progress. Despite initial successes, this woman may resist genuine moves to gain independence. Dependency in the therapeutic relationship should be challenged as a step toward growth and the prevention of setbacks. Without undermining her erroneous beliefs and the behaviors they engender, the patient may become inactive or withdraw from treatment, relapsing or regressing to her pretreatment level of adjustment. Only by adopting cognitive and interpersonal changes can she develop independence and a sense of self-worth. However, by breaking the entire dependency bond prematurely or trying to accomplish too much too soon, therapy may precipitate unwarranted emotions or erratic behavior.
As noted, the patient's initial receptiveness to short-term therapy may create the misleading impression that all forms of progress will be rapid. Despite real advances, she will probably seek to maintain a dependent relationship with the therapist. Despite signs to the contrary, she is likely to resist preliminary efforts to guide her into assuming independence and autonomy. Assisting her in relinquishing her dependency beliefs and habits need not prove difficult if the therapist employs a systematic program of cognitive and interpersonal methods. Efforts to help her build an image of competence and self-esteem can proceed one step at a time through a short-term program that strengthens her positive attributes and dislodges her negative habits of leaning on others.
End of Report
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MCMI-III™ Interpretive Report