Background to my interest in teaching children with autism

The Use of the MMPI in Teaching Personality Assessment, continued

Now, I have referred to these Basic Clinical Scales by name as well as numbers, partly because doing so has given me an opportunity to show how you can use these diagnostically-labelled scales to begin to explicate the diagnostic “entities” which underlie them, and partly because I want to say a few words about the idea of diagnostic entities itself.

Neophyte clinicians have a tendency to reify, if not deify, diagnostic constructs. They need to be specifically taught that the main purpose of psychological assessment is understanding, not classification (and this is particularly true within the prison system). Diagnoses are constructs, not entities. And individuals with the same diagnosis may be less similar in many ways than individuals with different diagnoses. In fact, that is one more advantage to the use of the MMPI in teaching personality assessment. These clinical scales are most frequently elevated in combination, mainly because the underlying diagnostic groups are not entirely dissimilar from each other. Marks and Seeman (1963), for example, found that about 70% of their psychiatric patients were depressed and anxious; and in fact, we find depression and anxiety items in most of these scales. So it is unlikely that one scale will be elevated and the others within normal limits. If that does happen, you are away to the races. But even if several scales are elevated, there is no need to despair, for two reasons. First, the frequent occurrence of clinical scale elevations in combination and the marvelous array of patterns which typically emerge serves as a reminder that the diagnostic labels associated with these basic clinical scales may capture something important about the psychology of the individual who obtains a high score on one of these scales, but they don’t begin to do justice to the complexity of personality. And second, the well-known empirical correlates of the various scale score elevations, singly or in combination, may provide an excellent basis for the beginning of a description of the individual in question but they can’t compare to the understanding which is available to the clinician who will take the time to examine in detail just what the individual has actually indicated about himself.

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