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Journal of Forensic Psychology Practice


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Guidelines for Forensic Application of the MCMI-III


Joseph T. McCann PsyD and JD

United Health Services Hospitals and the State University of New York Medical
UniversityClinical Campus, Binghamton, NY
Version of record first published: 15 Oct 2008

To cite this article: Joseph T. McCann PsyD and JD (2002): Guidelines for Forensic Application of the MCMI-III, Journal of
Forensic Psychology Practice, 2:3, 55-69
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Guidelines for Forensic Application


of the MCMI-III

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Joseph T. McCann, PsyD, JD

ABSTRACT. This article provides an overview of issues pertaining to


use of the Millon Clinical Multiaxial Inventory-III (MCMI-III) in forensic evaluations. Specific attention is given to the issue of admissibility,
general standards for use, advantages and disadvantages of using the
MCMI-III in forensic settings, and preparation of court testimony. Overall, several facets of the MCMI-III make it relevant and helpful in forensic evaluations. However, forensic experts must also be prepared to
acknowledge limitations of the test and should utilize test results in a manner that can be supported by empirical evidence. [Article copies available for
a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address:
<getinfo@haworthpressinc.com> Website: <http://www.HaworthPress.com> 2002
by The Haworth Press, Inc. All rights reserved.]

KEYWORDS. MCMI-III, forensic assessment, forensic use, admissibility, expert testimony

The use of psychological assessment instruments in forensic practice has


been the focus of considerable professional interest in recent years. A significant factor contributing to this trend is the fact that mental health professionals
are becoming increasingly more involved in the provision of forensic services.
One instrument that has been the focus of attention is the Millon Clinical
Joseph T. McCann is affiliated with the United Health Services Hospitals and the
State University of New York Medical UniversityClinical Campus, Binghamton,
NY.
Address correspondence to: Joseph T. McCann, 151 Leroy Street, Binghamton, NY
13905 (E-mail: Joseph_McCann@uhs.org).
Journal of Forensic Psychology Practice, Vol. 2(3) 2002
http://www.haworthpressinc.com/store/product.asp?sku=J158
2002 by The Haworth Press, Inc. All rights reserved.

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Multiaxial Inventory-III (MCMI-III; Millon, Davis, & Millon, 1997). The


MCMI-III is a multi-scale personality inventory that measures clinical syndromes and assesses them within the context of personality disorders, which
fosters a clearer understanding of the person.
McCann and Dyer (1996) originally recommended that forensic practitioners use the MCMI-II (Millon, 1987) because of limited validation research
that had originally been available on the MCMI-III. However, Dyer (1997)
subsequently revised this recommendation after a revised edition of the test
manual was published and noted that the MCMI-III was deemed suitable for
forensic application, a recommendation that has been made by McCann and
his colleagues (McCann, Flens, Campagna, Collman, Lassaro, & Connor,
2001). In general, the MCMI-III has been recognized as a useful instrument for
assessing clinical syndromes and personality disorders in a variety of forensic
populations. For instance, the MCMI-III been used in the assessment of domestic violence (Gondolf, 1999), child custody examinees (McCann et al.,
2001), violence risk (Kelln, Dozois, & McKenzie, 1998), and posttraumatic
stress disorder (Craig & Olson, 1997).
Forensic utility of the MCMI-III has not been without controversy. Some
scholarly debate has occurred over the appropriateness of the instrument in forensic settings. Rogers, Salekin, and Sewell (1999, 2000) stated that problems
with scientific validity and error rates should preclude admissibility of the
MCMI-III in forensic settings. On the other hand, McCann and Dyer (2000), as
well as Retzlaff (2000), outlined concerns about the methodology used by
Rogers and his colleagues to arrive at this conclusion and offered an argument
in favor of continued use of the MCMI-III in forensic evaluations. More recently, Schutte (2001) outlined a favorable position on use of the MCMI-III in
forensic settings.
The purpose of the present article is to provide an overview of issues pertaining to use of the MCMI-III in forensic evaluations, with particular attention to admissibility, general standards for use, advantages and limitations of
the MCMI-III, and preparation of court testimony.
ADMISSIBILITY AND FORENSIC STANDARDS
The admissibility of expert testimony is governed by evidentiary law that
exists in the particular jurisdiction in which the testimony is being offered. In
federal courts, for instance, admissibility of expert testimony is governed by
the Federal Rules of Evidence, which state that a witness may provide opinion
testimony if he or she qualified as an expert based on knowledge, skill, education, and/or training and that the opinion will assist the trier of fact understand

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evidence or to determine a fact at issue (McCann, 1998, in press). The helpfulness standard of the Federal Rules of Evidence has been further refined by
the U.S. Supreme Court decision in Daubert v. Merrell Dow Pharmaceuticals
(1993). The Daubert opinion outlined four criteria that judges may use when
determining if expert testimony is admissible. These criteria pertain to the
methods upon which an experts testimony is based and include whether or not
the theory or technique: (1) is capable of being tested; (2) has been subjected to
peer review; (3) has a known or potential rate of error; and (4) has been generally accepted in the field.
Another legal standard for admissibility is Frye test, which holds that expert
testimony is admissible if it is based on a methodology that has been sufficiently established to have gained general acceptance in the field to which it
belongs (United States v. Frye, 1923). For decades, the Frye test was the standard in most courts, but enactment of the Federal Rules of Evidence created a
competing standard in federal courts. Currently, the Federal Rules of Evidence, informed by Daubert, govern the admissibility of expert testimony in
all federal jurisdictions. In state courts, specific evidentiary standards for admissibility apply, although most states use the Frye standard, Daubert/Federal
Rules of Evidence standard, or some other evidentiary test of admissibility for
expert testimony (Hamilton, 1998). Forensic professionals are advised to be
knowledgeable about the specific evidentiary standard that applies in a given
jurisdiction.
Other standards for using psychological assessment methods in forensic
settings have been outlined in the professional literature. Heilbrun (1992) proposed the following guidelines for selection of psychological tests in forensic
evaluations: (1) commercial availability with a documented manual and peer
review; (2) reliability established at a level of 0.80 or explicit justification for
lower coefficients; (3) relevance of the test to some legal issue with appropriate validation research; (4) standard method of administration; (5) applicability to the population and purpose for which the test is used; (6) objective tests
with actuarial data applications; and (7) availability of a means for assessing
response style. Similarly, Marlowe (1995) provided a hybrid model for
operationalizing the admissibility of psychometric evidence using a blend of
scientific and legal principles. This hybrid model is based on many of the standards found in the Federal Rules of Evidence (e.g., relevance; scientific, technical, or specialized knowledge), as well as psychometric principles (e.g.,
reliability; validity).
The professional standards and legal tests of admissibility for expert testimony provide a suitable framework for analyzing admissibility and standards
of use for the MCMI-III in forensic evaluations. In the following section, pre-

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dominant considerations will be discussed with respect to the admissibility


and appropriateness of the MCMI-III for use in forensic evaluations.

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General Acceptance
As the major consideration under the Frye test and one of the major (but not
sole) considerations under the Daubert standard, general acceptance represents an important issue when evaluating the suitability of a forensic instrument in forensic evaluations. In People v. Stoll (1989) the court recognized
that diagnostic use of . . . personality inventories such as the MMPI and
MCMI has been established for decades (p. 711) and McCann and Dyer
(1996) noted that other courts have recognized the MCMI as a method that has
been generally accepted in the field of clinical psychology. More recently, surveys of professional patterns of psychological test usage have revealed the
MCMI to be the second most commonly used objective personality test in both
civil (Boccaccini & Brodsky, 1999) and criminal (Borum & Grisso, 1995) forensic evaluations. In child custody evaluations, the MCMI-II/MCMI-III was
cited as a commonly used instrument in a survey by Ackerman and Ackerman
(1997). A more recent survey of test usage in child custody evaluations revealed that the MCMI-II/MCMI-III is the second most commonly used test in
these types of forensic evaluations (Quinnell & Bow, 2001).
If one adopts patterns of psychological test usage in forensic settings as a
gauge of general acceptance, it is clear that the MCMI-III is generally accepted
in the field of forensic psychological evaluation. Although criticisms have
been directed toward the MCMI-III, there is no legal precedent that a scientific
technique or method must be accepted without controversy before it may be
deemed generally accepted in the field in which it belongs.
Standardization and Peer Review
The presence of a standard method for administering and scoring a
psychometric instrument has been recognized as a professional standard for
using a test in forensic settings (Heilbrun, 1992). Furthermore, peer review of a
theory or method is one of the considerations outlined in Daubert for assessing
the admissibility of expert testimony. The MCMI-III is commercially available from an established publisher of psychological assessment instruments
and has a technical manual that documents administration and scoring (Millon,
Davis, & Millon, 1997). Dyer (1997) and Retzlaff (2000) noted that there were
problems with the initial validation study presented in the first edition of the
test manual (Millon, 1994), and a revised manual, with a more detailed validation study, was subsequently published (Millon, Davis, & Millon, 1997).

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Therefore, clinicians using the MCMI-III in forensic settings should make reference to the most recent edition of the test manual (Dyer, 1997).
The MCMI-III has also been subjected to peer review. Although some commentary has been negative (Hess, 1998; Rogers et al., 1999, 2000), other commentary has been positive (Dyer, 1997; Dyer & McCann, 2000; Retzlaff,
1998; Schutte, 2001). Regardless of this disagreement, it would appear that the
MCMI-III meets the requirement of having undergone peer review and having
a standardized method of administration and scoring. For forensic purposes,
the most current edition of the manual (Millon, Davis, & Millon, 1997) should
be the principle reference (Dyer, 1997; Dyer & McCann, 2000).
Reliability and Validity
In the professional literature, psychometric properties of reliability and validity have been explicitly identified as relevant considerations when selecting
tests for use in forensic settings (Heilbrun, 1992; Marlowe, 1995). McCann
and Dyer (1996) noted that the MCMI-III has acceptable internal consistency
reliability in that most scales on the instrument have coefficients that exceed
the 0.80 criterion cited by Heilbrun (1992). Schutte (2001) noted that reliability data currently available on the MCMI-III reveal acceptable levels of both
internal consistency and test-retest reliability. However, he also noted that
[s]tudies of much longer test-retest durations are needed, particularly in light
of the fact that personal injury litigation often involves a debate of whether
present symptoms are pre-existing in nature or caused by the tort in question
(p. 9). This observation speaks to the limitations of interpreting MCMI-III
scales as measures of personality disturbances that are of a long-standing nature, but it does not constitute a lethal criticism of the reliability of the instrument. Overall, the reliability of the MCMI-III appears to meet or exceed
acceptable standards for forensic practice.
The validity of the MCMI-III has been evaluated in a number of studies.
Davis, Wenger, and Guzman (1997) reported on a validation study of the
MCMI-III scales that demonstrated that the instrument had criterion and diagnostic validity equivalent to that on previous editions of the instrument. Other
studies have examined validity of the MCMI-III for assessing depression (Davis & Hays, 1997), post-traumatic stress disorder (Craig & Olson, 1997), and
substance abuse (Craig, 1997). Dyer (1997) has noted that the MCMI-III has
excellent content validity when matched against DSM-IV (American Psychiatric Association, 1994) criteria, which has particular advantages for forensic
applications of the instrument given that DSM-IV criteria represent a standardized treatise of diagnostic criteria against which an experts opinion can be
compared. The fact that the developer of the MCMI-III, Theodore Millon, was

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also a principle member of the personality disorders workgroup of the


DSM-III and DSM-IV has also been cited as a strength of the MCMI-III for forensic purposes in that the instrument is aligned with the major diagnostic classification system used by mental health professionals (Dyer, 1997).
In general, research has supported validity of the MCMI-III scales. However, Rogers and his colleagues (Rogers et al., 1999, 2000) have cited problems with the MCMI-III, including criterion contamination in the revised
validity study of the instrument. While it is unclear how developers of the
MCMI-III might respond, it is important to note that independent research in
peer reviewed journals has supported the validity and clinical utility of the
MCMI-III.
Appropriateness of Population
A major concern that has often been cited with the MCMI-III is its appropriateness (or lack thereof) for use in forensic settings. This argument is based on
the observation that the instrument was developed for the evaluation of clinical
populations and that the MCMI-III may not be appropriate for forensic applications. One area of forensic practice where this issue has been explicitly
raised is in the area of child custody evaluations, where some have argued that
the clinical nature of the MCMI-III makes it inappropriate for use in child custody
evaluations (Ackerman, 1995; Ackerman & Ackerman, 1997; Otto & Butcher,
1995). The general concern is whether or not the MCMI-III overpathologizes
child custody examinees, or any other forensic sample, that might not match the
clinical sample upon which the MCMI-III was based.
Any discussion of the MCMI-IIIs appropriateness for forensic practice
must recognize that the instrument differs from other self-report instruments in
that it is a criterion referenced, rather than a norm referenced test. In other
words, interpretation of MCMI-III results examines the probability that a
given individual has a target diagnosis or possesses the characteristics of a specific clinical syndrome when that persons score exceeds a particular cutoff on
any given scale. The MCMI-III does not utilize norm referencing, where interpretation of raw scores is based on how the person compares to the scores from
the standardization sample in terms of deviation from the mean. McCann and his
colleagues (2001) examined whether or not the MCMI-III overpathologizes
child custody examinees and found that with the exception of Scales 4 (Histrionic) and 7 (Compulsive), and to a lesser extent Scale 5 (Narcissistic), for females, the MCMI-III does not overpathologize child custody examinees. The
responses of individuals undergoing a child custody evaluation reflect a socially desirable response set (Halon, 2001; McCann et al., 2001) and are similar to non-clinical populations that have taken the MCMI. McCann and his

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colleagues recommended adjustments that clinicians can make to reduce the


likelihood of false positive errors on those few scales where child custody
examinees tend to score higher. However, McCann and his colleagues interpreted their findings as providing support for continued use of the MCMI-III in
child custody evaluations.
To date, concerns that the MCMI-III overpathologizes individuals undergoing forensic evaluations have not been supported by empirical data. It is important to remember that forensic cases were included in the standardization
sample of the MCMI-III and that the instrument was designed for use with individuals who evidence problematic emotional and interpersonal symptoms or
who are undergoing professional psychotherapy or a psychodiagnostic evaluation (Millon, Davis, & Millon, 1997, p. 6, emphasis added).
Rate of Error
A major criterion for admissibility of expert testimony outlined in the
Daubert opinion is whether or not a theory or method has a known, or potentially known, rate of error. In this regard, the MCMI-III is well-suited for forensic assessment because the primary method for interpreting results has been
framed in terms of operating characteristics such as positive predictive power,
negative predictive power, sensitivity, and specificity (Dyer, 1997; McCann &
Dyer 1996). When interpreting predictive power values for the MCMI-III, it is
important to keep in mind the base rates of specific personality disorders and
clinical syndromes. In the MCMI-III manual, the positive predictive ratio is
presented for each scale as a measure of the degree to which a positive elevation on an individual scale represents an increase over chance that a given individual has the target diagnosis when the test shows positive (Millon, Davis,
Millon, 1997). For the personality disorder scales, the positive predictive ratios range from 4.24 (Scale 2B: Depressive) to 32.76 (Scale 6B: Sadistic),
meaning that the personality disorder scales of the MCMI-III provide a significant increment beyond chance in helping to establish if the individual has the
target diagnosis.
It is also important to note that the negative predictive power (i.e., the likelihood that a person does not have the diagnosis knowing that the test results are
negative) for each of the MCMI-III scales is above 0.90 (Retzlaff, 2000).
Given that the positive predictive power (i.e., the likelihood that a person has
the diagnosis knowing that the test results are positive) for the MCMI-III
scales range from 0.33 on Scale PP to 0.93 on Scale T, the MCMI-III appears
better suited for ruling out, rather than ruling in, a specific diagnosis. Nevertheless, competent use of the MCMI-III for forensic purposes calls for test re-

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sults to be used in conjunction with interview data, collateral information, and


other test data when rendering conclusions in a case.

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Response Style
Heilbrun (1992) stated that there should be some method for evaluating a
persons response style when psychological tests are used in forensic evaluations. This recommendation is based on the common observation that individuals undergoing a forensic psychological evaluation may have an incentive to
distort their self-reports in some way. For instance, individuals undergoing a
child custody evaluation are motivated to present themselves in a favorable
manner and will often minimize personal concerns or difficulties (Bathurst,
Gottfried, & Gottfried, 1997; McCann et al., 2001). In other cases, such as
those involving personal injury or criminal responsibility, the individual may
be motivated to exaggerate or malinger psychological disturbances.
A major drawback of the first version of the MCMI (MCMI-I; Millon,
1983) was the lack of specialized scales to evaluate response style. Subsequent
revisions of the test, including the MCMI-II (Millon, 1987) and MCMI-III
(Millon, Davis, & Millon, 1997), included a number of indices and scales to
evaluate distortions in response set. A recent study by Daubert and Metzler
(2000) examined the effectiveness of Scales X (Disclosure), Y (Desirability),
and Z (Debasement) on the MCMI-III for detecting both fake-good and
fake-bad profiles. Their findings indicated that the MCMI-III was moderately
effective in identifying both fake-good and fake-bad profiles, although these
researchers found that alternative cutoffs (e.g., low Scale Z scores as a measure
of social desirability) may be more effective than standard cutoffs for these
scales. While the MCMI-III is helpful for providing corroborative evidence of
response set, it is important to supplement results from the MCMI-III with data
from other instruments, interview data, and collateral reports when evaluating
issues related to response set in forensic cases.
Helpfulness
The helpfulness standard outlined in the Federal Rules of Evidence states
that for expert opinion testimony to be admissible, it must assist the trier of fact
(i.e., judge or jury) to understand evidence or determine a specific issue. The
MCMI-III is not likely to be of particular use to the trier of fact unless a qualified expert is available to interpret the test results and apply them to a specific
piece of evidence or legal issue in a case. In this regard, the experts opinion is
more likely to be the focus of a determination of helpfulness. In general, there
is a clear trend in case law that when expert testimony based, in part, on psy-

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chological testing is deemed inadmissible, it is more often because of the manner in which the expert used the psychological testing or applied the data in the
case, rather the specific qualities of the psychological test (McCann, in press).
The guidelines outlined by Heilbrun (1992) and Marlowe (1995) provide that
testimony based on psychological test data must be relevant and that experts
must not draw conclusions that cannot be supported by the data. In other
words, the expert must rely on psychometric data in a manner that is reasonable and must make sure that inferences drawn from the data can be supported
by research.
ADVANTAGES AND LIMITATIONS
Within the context of a comprehensive forensic psychological evaluation,
psychological test data represent only one component of all the information
that ultimately enters into final conclusions and recommendations. There are
strengths and limitations with each individual assessment method that should
be recognized if a forensic expert is to use tests ethically, fairly, and competently. The MCMI-III is like other psychological tests in that there are specific
advantages and limitations associated with its use. By recognizing both ways
in which the MCMI-III is advantageous and ways in which there are limits associated with its use, the forensic expert will be able to avoid drawing conclusions from test results that cannot be supported by the research data.
One of the major advantages of the MCMI-III is that interpretation is guided
by precise classification rules for making diagnostic decisions (Craig, 1999).
More specifically, McCann and Dyer (1996) noted that the MCMI-III holds
advantages over other self-report instruments because interpretation employs
diagnostic classification properties of sensitivity (i.e., the likelihood that the
test will be positive given that a diagnosis is present), specificity (i.e., the likelihood that the test will be negative given that a diagnosis is absent), positive
predictive power (i.e., the likelihood that a person has a diagnosis knowing that
the test is positive), and negative predictive power (i.e., the likelihood that a
person does not have the diagnosis knowing that the test is negative). These diagnostic properties fit with the growing need for forensic experts to establish a
rate of error for the principle or method that forms the basis for testimony.
For example, suppose a civil litigant claiming posttraumatic stress disorder
in a personal injury case scores at a BR of 70 on Scale R (Post-Traumatic
Stress) of the MCMI-III. This finding means that the test results alone suggest
the absence of the disorder. Using information obtained in Table 4.4 of the
MCMI-III manual (Millon, Davis, & Millon, 1997, p. 100), an expert will find
that the sensitivity of this scale is 82, meaning that while the test will identify

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those who have posttraumatic stress disorder 82% of the time, 18% of those individuals who have posttraumatic stress disorder (i.e., the false negative rate,
or 1-Sensitivity) will be missed by the test. This information is useful for anchoring further diagnostic analysis in the case when the expert attempts to determine, using other sources of data, whether the person who took the
MCMI-III does (i.e., is a true negative) or does not (i.e., is a false negative)
have posttraumatic stress disorder. This example illustrates how the MCMI-III
operating characteristics can apply general error rates when rendering diagnostic conclusions.
Other advantages of the MCMI-III for forensic purposes include its excellent internal consistency reliability (Dyer, 1997; McCann & Dyer, 1996) and
content validity (Dyer, 1997). The MCMI-III scales parallel DSM-IV diagnoses and the developer of the instrument was a member of the DSM-IV task
force. These factors constitute other advantages of using the MCMI-III in forensic evaluations because the DSM-IV has increasingly become the standard
diagnostic treatise for evaluating the accuracy of mental health diagnoses
(Dyer, 1997).
For instance, suppose the victim in a sexual assault case is suing for personal injuries sustained in the incident. Results from a psychological evaluation reveals a modest elevation (i.e., BR=77) on Scale 4 (Histrionic) of the
MCMI-III and efforts by the defense are made to construe this finding as indicative of a personality disorder characterized by sexually seductive and provocative behavior. A review of Table 2.2 in the MCMI-III manual (Millon, Davis, &
Millon, p. 34) can be used to identify specific items on Scale 4 that pertain to
this specific feature of histrionic personality disorder. If the subject failed to
endorse items related to this feature, the expert can confront such efforts by
noting specific MCMI-III items that correspond to particular DSM-IV personality disorder features.
The MCMI-III is useful for evaluating specific psychological issues that
may be relevant in an individual forensic case. For instance, a scale not found
on the MCMI-II but which was added to the MCMI-III is Scale R (Post-traumatic Stress), which can be of particular use in civil cases involving allegations of trauma. Craig and Olsen (1997) reported on findings that supported the
validity of this scale, although strict reliance on MCMI-III results alone for assessing posttraumatic stress disorder is not advised. Additionally, the
MCMI-III personality disorder and clinical syndrome scales are differentiated
into basic and severe scales that can be useful for assessing the relative severity
of psychopathology. The instrument has also been used successfully to classify various types of known offenders (cf. Gondolf, 1999). McCann and Dyer
(1996) outlined the various forensic cases in which the Millon inventories can
be applied, including civil, criminal, and family court matters.

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There are also limitations that must be recognized when using the
MCMI-III in forensic cases. One of the more significant limitations is the fact
that, like other self-report measures, there is the potential for response bias that
can distort test results. Although the MCMI-III has specific scales that can be
used to evaluate distorted responding (i.e., Scales X, Y, and Z), there are some
cases where the MCMI-III results may be technically valid but the resulting
profile does not accurately represent the person taking the test. The individual
MCMI-III items are face valid, in that someone taking the test is often able to
appraise the content matter being sampled by an item and which response (i.e.,
True or False) is indicative of psychological adjustment or maladjustment. Therefore, some individuals taking the test may be able to distort their
responses in the desired direction or to present their symptoms and personality
propensities as they wish them to be viewed by the examiner. Although face
validity of the MCMI-III items helps to insure that the test samples relevant
domains of personality and clinical symptomatology, the test remains prone to
some of the limitations inherent in self-report methodology. Moreover, false
positive and false negative errors can sometimes occur and therefore forensic
professionals should never rely on MCMI-III results alone when drawing conclusions. Test results should be interpreted in light of other psychometric data,
clinical history, collateral reports, and records reviewed in a particular case.
Related to the issue of error rate in MCMI-III scale elevations is the fact that
the interpretive reports may sometimes contain incorrect or misleading information about the person taking the test. McCann and Dyer (1996) have recommended against using the interpretive reports in forensic cases because of this
issue. There have been no recent developments in the MCMI-III literature that
would support a change in this recommendation. Therefore, professionals are
advised to avoid reliance on the interpretive reports and to interpret the
MCMI-III in light of existing research, as well as information obtained during
the course of the evaluation.
THE MCMI-III AND COURT TESTIMONY
McCann and Dyer (1996) outlined several recommendations for preparing
court testimony on the Millon inventories that are relevant to the MCMI-III. In
particular, they recommended that experts begin their preparation early, even
before beginning the evaluation. In this regard, the forensic expert must determine the specific issues that are being evaluated in a case and whether or not
the MCMI-III will provide meaningful and useful information on these issues.
Although McCann and Dyer (1996) favored the MCMI-II and recommended
against use of the MCMI-III in forensic cases, this recommendation was based

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on inadequate documentation of validity in the original version of the test manual. There has been a revision of the MCMI-III manual (Millon, Davis, &
Millon, 1997) and the MCMI-III has been endorsed for use in forensic evaluations (Dyer, 1997; McCann et al., 2001).
Craig (1999) has also noted some important issues to recognize when organizing and preparing testimony on the MCMI-III. The extent to which previous
MCMI research applies to the MCMI-III is questionable, in that there was a considerable degree of change from the MCMI-II to the MCMI-III (e.g., 95 of 175
items were revised; Craig, 1999). Therefore, experts should rely as much as possible on current research when interpreting the MCMI-III. In addition, experts
should be very conversant on the topic of diagnostic power and operating characteristics of the MCMI-III. McCann and Dyer (1996) outlined ways in which
experts might frame these properties in language that can be easily grasped by
lay jurors.
It is worth noting that forensic experts who use the MCMI-III are likely to encounter vigorous opposition to use of the instrument in their forensic assessments
(cf., Rogers & Shuman, 2000). There are numerous pseudo-debates in the literature about the appropriateness or inappropriateness of various assessment instruments in clinical and forensic practice (see the introduction to this special series;
Gacono, 2002). While it is important for professionals to recognize that their work
will undergo intense scrutiny in the forensic arena, such debate does not need to
dictate which specific methods an expert chooses to employ. It is worth noting that in
his opinion in Daubert v. Merrell Dow Pharmaceuticals (1993), Justice Blackmun
stated that the appropriate means for dealing with evidence is vigorous cross-examination, presentation of contrary evidence, and careful instruction on the burden of
proof (p. 278). The forensic expert who uses the MCMI-III must be prepared to
foresee questions that will arise during cross examination and to counter any attacks by citing appropriate professional literature.
When preparing court testimony, it may be helpful for experts to remember
the following: (1) early preparation is important; (2) use the proper version of
the MCMI-III; (3) rely on the most current edition of the test manual; (4) explain operating characteristics in simple terms; (5) recognize that the
MCMI-III can yield four different types of results (i.e., true positives, true negatives, false positives, and false negatives) and be able to explain why errors
may have occurred; (6) acknowledge both advantages and limitations to using
the MCMI-III; and (7) link MCMI-III results to other sources of data.
CONCLUSION
The MCMI-III has gained prominence in recent years in that more practitioners appear to be using the test to assess a variety of psychological issues in fo-

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rensic matters. There are several areas where the test has been used, including
criminal, civil, and family cases. Several distinct advantages have been noted
for using the MCMI-III in forensic evaluations, including excellent internal
consistency reliability and content validity, interpretation that is guided by objective decision rules, correspondence with DSM-IV criteria, and a broad
range of scales that assess response style, personality disorders, and clinical
syndromes. However, the MCMI-III is like other psychometric instruments
that have become the subject of debate. Forensic experts who select the
MCMI-III for use in their forensic evaluations can address any concerns that
may arise by citing appropriate research and literature that supports forensic
use of the MCMI-III. Several key references exists for such issues as test validity (Craig, 1997; Craig & Olsen, 1997; Davis, Wenger, & Guzman, 1997;
Millon, Davis, & Millon, 1997), prediction of violence (Kelln, Dozois, &
McKenzie, 1998), child custody evaluations (Halon, 2000; McCann et al.,
2001), preparation of testimony (Craig, 1999; McCann & Dyer, 1996; Schutte,
2001) and interpretation of diagnostic operating characteristics (Dyer, 1997;
McCann, Dyer, 1996). Experts should also interpret test results within the context of a comprehensive evaluation that incorporates other pieces of information and should make sure that test data have some rational and empirically
validated relationship to the issues being assessed.
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RECEIVED: 02/01/02
REVISED: 02/01/02
ACCEPTED: 02/01/02

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