Minnesota Multiphasic Personality Inventory, By Denis William Keyes

MENTAL RETARDATION

VOLUME

42,

NUMBER

2: 151–153

APRIL

2004

Use of the Minnesota Multiphasic Personality Inventory (MMPI) to Identify Malingering Mental Retardation
Denis William Keyes

Since 1988, I have been active in cases involving the death penalty and offenders with mental retardation. Because of serious concerns about these individuals, and from several experiences in this arena, I have written and coauthored articles on mental retardation and criminal justice, most of which deal with cases of Death Row inmates who have mental retardation. One of these articles (Keyes, Edwards, & Perske, 1997) was subsequently cited by the United States Supreme Court in the Atkins v. Virginia case (2002). No matter one’s opinion about the death
penalty, the execution of people with mental retardation cannot be considered justice. In Atkins, the U.S. Supreme Court has agreed with the stance of the American Association on Mental Retardation (AAMR) on this issue. In light of the importance of this decision and its subsequent impact on the courts and the status of many Death Row inmates, each state that has the death penalty (but no statutory exclusion for people with mental retardation) has been actively working, both legislatively and through litigation, to determine regulations for dealing with the Atkins decision (Ellis, 2003). This is all well and good, except for the inevitable concern that inmates without disabilities may attempt to use Atkins as a method of relief from execution by ‘‘malingering’’ mental retardation. This is not a new issue. Fourteen years ago, I was involved in the federal appeal of an Arkansas case that involved the approaching execution of a man who was tested with the Wechsler Adult Intelligence Scale-Revised (WAIS-R) (Wechsler, 1980) and was found to have a Full Scale IQ of 63. The Arkansas attorney general subsequently demanded that their expert also be given the opportunity to test the inmate and asked counsel (who then asked me) which test should be administered. My response was that the Stanford-Binet Intelligence Scale–Fourth Edition (Thorndike, Hagen, & Sattler, 1986) was the obvious choice. In her evaluation, the state’s psychologist determined that the

inmate’s Composite Score on the Stanford-Binet was 60. Given the correlation between these two instruments (.91 for those editions, as reported in the Stanford-Binet technical manual), the determination of the first prong of the AAMR definition was clearly achieved (as it had been when the man was in school several years earlier); it merely supported prior evidence. That was on a Saturday. However, when the state’s psychologist testified the following Monday, she stated that, in her opinion, the inmate had malingered throughout the testing. When I took the stand on the following Wednesday, I noted that I saw no indications of malingering and that both the profiles and the IQs were virtually identical, separated only by 3 points in the full scale scores of each. The similarities in both of our results, if anything, would suggest that the inmate could not have been malingering. The judge then asked me, from the bench, if there was research to back up the assumption that the scores corroborated each other and prove the inmate was not malingering. Other than concurrent validity research on the tests themselves, I admitted that I knew of no such research on malingering. (I note that this federal judge did such a thorough job of questioning that the assistant attorney general declined to cross-examine me. The inmate, though he did have mental retardation, was executed a few years later (see Fairchild v. Lockhart, 1989). Now, in light of Atkins, the Mississippi Supreme Court has made a series of rulings that can only be seen by qualified mental retardation professionals as erroneous (Foster v. State, 2003; Russell v. State, 2003; Goddin v. State, 2003; Wells v. State, 1998). This court has consistently ruled that in an effort to identify those inmates who may be attempting to malinger mental retardation, the Minnesota Multiphasic Personality Inventory (MMPI2) must be administered to all condemned prisoners filing applications under the Atkins ruling (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989; Hathaway & McKinley, 1989).

American Association on Mental Retardation

151

MENTAL RETARDATION

VOLUME

42,

NUMBER

2: 151–153

APRIL

2004

Perspective: Malingering mental retardation

D. W. Keyes

The MMPI-2 has several so-called ‘‘validity’’ scales that are supposed to identify those examinees who are not being truthful in their responses.
Although I am not specifically criticizing the use of this instrument in the general population, Mississippi’s Supreme Court is making a fundamental error. Had any of these justices or their staff taken the time to consult with any professional experienced in the assessment of people with mental retardation, they could have learned about this test and avoided making a very serious judicial error. The problem arising from these decisions cannot be overstated. First, according to the first paragraph of the introduction in the MMPI-2 manual, this measure is a broad-band test designed to a number of the major patterns of personality and emotional disorders. In the manual Hathaway and McKinley (1989) noted that ‘‘An eighth-grade elementary-school level of reading comprehension is required, as is a satisfactory degree of cooperation and commitment to the task of completing the inventory’’ (p. 1). Here lies the first of the problems with the Mississippi Court’s ruling: People with mental retardation almost never achieve a reading comprehension level (or an oral language comprehension level, for that matter) of that expected of a typical eighth grader. Given this fact, the MMPI-2 is already inappropriate for people with mental retardation; therefore, using it as a method of helping to diagnose the existence of mental retardation is ludicrous.
Second, the MMPI-2 manual contains the statement
The usefulness of the information obtained by the MMPI-2 depends heavily on the ability of the test subject to understand the test instructions, to comply with the requirements of the task, to comprehend and interpret the content of the items as they relate to him or her, and to record these self-attributions in a reliable way (Hathaway & McKinley, 1989, p. 13, italics added).

person who has mental retardation should see the futility of it either before or very shortly after reading the first question to the examinee. Third, realizing the basic truth of the above statements, the MMPI authors continued by saying:
A number of physical conditions or emotional states may impair this ability. It is vital that the test administrator be alert to the presence of one or more incapacitating conditions, such as: limited visual acuity, dyslexia or receptive aphasia, learning disorder, drug or alcohol intoxication or withdrawal states, toxic reactions to various infectious agents or other organic deliria, disorientation arising from brain injury or concussion, post-seizure confusion in an epileptic disorder, residual neurological impairment (Hathaway & McKinley, 1989, pp. 13–14, italics and boldface added).

Clearly, the authors of the MMPI-2 did not intend for this instrument to be administered to people with mental retardation. Finally, the MMPI-2 manual authors stated that,
Any administration of the MMPI-2 must be carried out in a way that guarantees the test subject or client privacy, freedom from distractions and intrusions, and full assurance that the results of the examination will be respected, protected, ‘‘and used for the benefit and enhancement of his or her welfare’’ (Hathaway & McKinley, 1989, p. 13, italics added).

In my nearly 30 years of working with people who have mental retardation, I can say unequivocally that this requirement is beyond the ability of anyone who has mental retardation. The reason for this is simple: This test has 567 individual questions that must be answered by the subject. No person with mental retardation whom I have ever assessed could retain the required level of concentration for the amount of time necessary to listen to, accurately comprehend, and correctly answer 567 oral questions. More to the point, any psychiatrist or psychologist attempting to administer the MMPI to a

It should be clear that given the last part of this statement, no ethical psychologist could administer this instrument in an attempt to provide the state with evidence that could and would result in the judicial execution of the test subject. There are, however, other instruments that have been used to gauge, with reasonable accuracy, whether or not an inmate has been attempting to malinger responses on tests. For example, the Test of Memory Malingering (Tombaugh, 1996) has been used to successfully determine factors of malingering (Baroff, 2003) and is not nearly as cumbersome as the MMPI. In light of the U.S. Supreme Court’s ruling in Atkins v. Virginia, the continued vulnerability of those who have mental retardation and are in the criminal justice system, and given the clear warnings in the MMPI manual, the courts must realize that using a test such as the MMPI to determine malingering is an egregious error and certainly one that does not serve the purpose of justice, particularly for people who have mental retardation.

References
Atkins v. Virginia (536 U.S. 304 [2002]). Baroff, G. (2003). Mental retardation and the law:

152

American Association on Mental Retardation

MENTAL RETARDATION

VOLUME

42,

NUMBER

2: 151–153

APRIL

2004

Perspective: Malingering mental retardation

D. W. Keyes

Atkins v.
Virginia. Paper presented at the 111th annual conference of the American Psychological Association. Toronto, Ontario. Butcher, J., Dahlstrom, W., Graham, J., Tellegen, A., & Kaemmer, B. (1989). Manual for administration and scoring: Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Minneapolis: University of Minnesota Press. Ellis, J. (2003). Mental retardation and the death penalty: A guide to state legislative issues. Available at www.aamr.org. Fairchild v. Lockhart, 744 F. Supp. 1429 [ED. Ark. 1989] Foster v. State, 848 So.2d 172 [Miss. 2003] Goddin v. State, 2003 WL 21805386 [Miss. Aug 7, 2003] Hathaway, S., & McKinley, J. C. (1989). Minnesota Multiphasic Personality Inventory (MMPI-2). Columbus, OH: Merrill/Prentice-Hall. Keyes, D., Edwards, W., & Perske, R. (1997). People with mental retardation are dying—Legally. Mental Retardation, 35,
59–63.

Russell v. State, 849 So.2d 95 [Miss. 2003] Thorndike, R., Hagen, E., & Sattler, J. (1986). Guide for administering and scoring the Stanford-Binet Intelligence Scale: Fourth Edition. Chicago: Riverside. Tombaugh, T. (1996). Test of Memory Malingering. North Tonawanda, NY: Multi-Health Systems, Inc. Wechsler, D. (1980). Wechsler Adult Intelligence Scale-Revised (WAIS-R). San Antonio, TX: Psychological Corp. Wells v. State, 1998-DR-01280-SCT

Author: Denis William Keyes, PhD, Associate Professor of Special Education, Department of Foundations, Secondary and Special Education, School of Education at The College of Charleston, Charleston, SC 29424. E-mail: [e-mail].

American Association on Mental Retardation

153