The MMPI-3 is the third edition of theMinnesota Multiphasic Personality Inventory, a psychological self-report test used to evaluate a wide range of mental health conditions and personality traits. It consists of over 350 true/false questions and provides scores on validity, clinical, and personality scales.
Five scales detect feigned mental disorders, yield information relevant for differential diagnosis, indicate the therapeutic prognosis, and unveil personality characteristics predictive of psychosocial functioning.
Compared to previous versions, MMPI-3 was updated to have better psychometric properties and capture a wider range of psychiatric conditions listed in the DSM-5.
Key Points
Rationale
Previous research on transgender and gender-diverse (TGD) mental health has relied almost exclusively on screening measures rather than comprehensive assessments of personality and psychopathology like theMinnesota Multiphasic Personality Inventory(MMPI; Hathaway & McKinley, 1943) family of tests (Bryant et al., 2021).
Studies using older MMPI versions with TGD samples found the Masculinity-Femininity scale was often elevated, but evidence for other Clinical Scale elevations was mixed (Caron & Archer, 1997; Greenberg & Laurence, 1981; Miach et al., 2000).
However, the MMPI-2-RF norms were collected over 30 years prior to the TGD data. The present study replicated this prior work to address potentialcohort effectsusing the newly released MMPI-3 (Ben-Porath & Tellegen, 2020a) and concurrent samples.
Method
The total TGD sample consisted of 97 TGD adults who completed the MMPI-2-RF-Expanded (MMPI-2-RF-EX) booklet. This measure includes all MMPI-2-RF and MMPI-3 test items, allowing MMPI-3 scale scores to be derived.
Thirteen additional participants were excluded for producing technically invalid MMPI protocols. Participants were recruited throughout the Midwest and Southwest United States.
Materials included the MMPI forms and criterion measures of impulsivity, anxiety, depression, unusual beliefs, posttraumatic symptoms, and resilience.
MMPI-3 scores were compared for reliability across the total TGD sample, normative sample (N = 1,620), and an outpatient clinical sample (N = 315).
Sample
The TGD sample was 36 years old on average. Most participants identified as transgender female (53%) or transgender male (26%),
White (77%), and having at least some college education (80%). Fifty TGD individuals were not in mental health treatment, and 47 were currently in treatment.
The MMPI-3 normative sample (N = 1,620) was demographically matched to 2020 U.S. Census projections. The clinical sample (N = 315) consisted of mental health outpatients from a community mental health center.
Statistical Measures
Mean differences were tested with independent samples t-tests, using Hedges’ g as the effect size measure.
Results
The MMPI-3 scales showed similar reliability when given to transgender individuals versus the general population. This means the test was measuring psychological constructs consistently across these groups.
When looking at validity – whether the test accurately captured mental health difficulties transgender people face – the MMPI-3 scales largely worked as expected. Scales tied to issues like anxiety, depression, and trauma correlated with separate measures of those problems in transgender individuals.
Transgender people not currently getting mental health treatment scored higher on several MMPI-3 scales related to emotional problems compared to the general public (they showed far higher suicide risk).
Transgender patients already in mental health treatment scored much higher than transgender people not in treatment on scales covering feelings of depression, anxiety, hopelessness, and more. This matches the expectation that seeking treatment signals greater distress.
Sores for transgender mental health patients were very close to scores for cisgender patients on almost all scales – except transgender individuals showed higher suicide risk even when in treatment. So this ongoing elevated risk seems uniquely tied to their gender minority status.
Insight
This investigation demonstrates initial evidence that the MMPI-3 functions similarly in TGD versus cisgender samples.
Reliability results suggest the MMPI-3 is consistently measuring its intended constructs when administered to TGD individuals. Validity findings provide preliminary support that expected psychological difficulties can be detected among TGD persons.
Overall, this investigation sets the foundation for additional research establishing the MMPI-3 as an assessment tool that can identify areas of psychopathology to address when working with TGD clients to provide culturally-informed treatment.
Strengths
Limitations
Implications
Given findings of heightened emotional difficulties and suicide risk among TGD individuals versus norms and clinical samples, directing attention to internalizing problems and suicidality when formulating treatment plans for TGD clients seems especially warranted based on this investigation.
The MMPI-3 scales displaying the largest elevations in the TGD clinical subsample compared to norms also denote specific areas of dysfunction that could be addressed through targeted interventions. These encompassed demoralization, hopelessness, self-doubt, anxiety, social introversion, and family problems.
References
Primary reference
Bryant, W. T., Livingston, N. A., McNulty, J. L., Choate, K. T., Santa Ana, E. J., & Ben-Porath, Y. S. (2024). Exploring the Minnesota Multiphasic Personality Inventory (MMPI)-3 in a transgender and gender diverse sample.Psychological Assessment, 36(1), 1–13.https://doi.org/10.1037/pas0001287
Other references
Ben-Porath, Y. S., & Tellegen, A. (2008). Minnesota Multiphasic Personality Inventory-2-Restructured Form: Manual for administration, scoring, and interpretation. University of Minnesota Press.
Ben-Porath, Y. S., & Tellegen, A. (2020a). Minnesota Multiphasic Personality Inventory-3 (MMPI-3): Manual for administration, scoring, and interpretation. University of Minnesota Press.
Bryant, W. T., Livingston, N. A., McNulty, J. L., Choate, K. T., & Brummel, B. J. (2021). Examining Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scale scores in a transgender and gender diverse sample. Psychological Assessment, 33(12), 1239-1246.https://doi.org/10.1037/pas0001087
Caron, G. R., & Archer, R. P. (1997). MMPI and Rorschach characteristics of individuals approved for gender reassignment surgery. Assessment, 4(3), 229-241.https://doi.org/10.1177/107319119700400303
Greenberg, R. P., & Laurence, L. (1981). A comparison of the MMPI results for psychiatric patients and male applicants for transsexual surgery. Journal of Nervous and Mental Disease, 169(5), 320–323.https://doi.org/10.1097/00005053-198105000-00010
Hathaway, S. R., & McKinley, J. C. (1943). The Minnesota Multiphasic Personality Inventory. University of Minnesota Press.
Miach, P. P., Berah, E. F., Butcher, J. N., & Rouse, S. (2000). Utility of the MMPI-2 in assessing gender dysphoric patients. Journal of Personality Assessment, 75(2), 268-279.https://doi.org/10.1207/S15327752JPA7502_7
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Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
