Why Use the MMPI-2 When the DSM5 No Longer Uses Those Diagnoses?

This was a question that I was asked at a recent lecture I gave on comparing the DSM5, ICD-10 and the PDM (see slides). “After all there is no “psychopathic deviate” but now “anti-social.” There is no “hypochondriasis” and “hysteria.” There is no “psychasthenia.” So the MMPI-2 must be obsolete.

It true that hypochondria and hysteria are condensed in the DSM5 as “Somatic Symptoms and Related Disorders.” The DSM5 does a lot of condensing of diagnoses. But within “Somatic Symptoms and Related Disorders” are subtype codes for hysteria but they are simply called “Conversion disorders.” The ICD-10 also uses the term “Conversion disorder.” The term comes from the fact that the unconscious conflicts are converted to symbolic physical appearing symptoms. Relabeling is very common. It is based on what is popular and not what is more scientifically valid. The Hysteria scale on the MMPI-2 measures both the overt symptom of conversion hysteria and Histrionic Personality disorder (which is in the DSM5, ICD 10 and PDM).

Hypochondriasis is a distinct syndrome from a Histrionic syndrome. The former has much less of an identity and a capacity for intimacy. Their identity is based on their having physical symptoms. The person with a histrionic syndrome is also self centered but usually has a better sense of self and others. The DSM5 now states that antisocial personality disorder is interchangeable with psychopathic or sociopathic.

Psychasthenia includes obsessive compulsive reactions and phobias. Psychasthenia (scale 7) is not in the DSM5. Currently Psychasthenia can be billed as the code 300.89 in ICD-9 and is billed under F48.8 in ICD-10. There are plenty of self-reports out there with the names of the scales labeled by the authors to the changing DSM or ICD labels. The fact that you see a new label is not the same as greater construct or predictive validity. The MMPI is the ONLY self-report of psychopathology that is criteria based. It is based on actual people with the disorders. The other self-reports are based on mathematical assumptions and the authors’ choice of groupings and labeling.

The MMPI-2 is still the most valid self-report of defenses and psychopathology. Do not get confused by people who vote to put new labels on old wine. (See the slides http://www.youtube.com/watch?v=DXFeHfHUlIE)