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� Journal of Personality Assessment, 93(1), 26–32, 2011 Copyright C Taylor & Francis Group, LLC ISSN: 0022-3891 print / 1532-7752 online DOI: 10.1080/00223891.2011.529011

ARTICLES

Reliability and Validity of the Spanish Version of the Minnesota Multiphasic Personality Inventory–Adolescent (MMPI–A)

IHAB ZUBEIDAT,1 JUAN CARLOS SIERRA,2 JOSÉ MARÍA SALINAS,2 AND ANTONIO ROJAS-GARCÍA2

1Special Education Department, Sakhnin College for Teacher’s Education, Sakhnin, Israel 2Facultad de Psicologı́a, Universidad de Granada, Granada, Spain

The aim of this study was to determine the test–retest reliability and internal consistency of the scales of the Spanish version of the Minnesota Multiphasic Personality Inventory–Adolescent (MMPI–A; Butcher et al., 1992). Two samples of 939 and 109 Spanish adolescents ages 14 to 18 years were assessed with the MMPI–A in their school environment. The frst sample responded to the inventory once, whereas the second sample responded to it on 2 occasions with a 2-week interval between sessions. Results showed no signifcant differences in means or variances between the frst and the second test administration for most MMPI–A scales. Test–retest reliability ranged between .62 (Amorality, Ma1) and .92 (Immaturity, IMM); most correlations exceeded .70. Internal consistency values for the MMPI–A scales in the pretest and posttest were very similar overall. External validity of the MMPI–A was demonstrated through several signifcant correlations between its scales and YSR/11–18 syndromes and social interaction measures. The highest correlations were established between the Anxious/Depressed YSR/11–18 scale and other MMPI–A scales such as Schizophrenia (Sc), Welsh’s Anxiety (A), Adolescent-Anxiety (A-anx) and Adolescent-Alienation (A-aln), and between the Social Avoidance and Distress Scale and the MMPI–A Adolescent-Social Discomfort (A-sod) scale.

The Minnesota Multiphasic Personality Inventory–Adolescent (MMPI–A; Butcher et al., 1992) is made up of 478 items that assess a number of aspects of personality—up to 70 variables— using different groups of scales: validity, clinical, content, and supplementary scales, as well as subscales. The MMPI–A is most frequently used in psychological, psychiatric, medical, alcohol and drug treatment, and correctional clinical contexts. It can be applied individually or in groups to adolescents ages 14 to 18 years.

Traditional validity scales, largely carried over from the orig- inal MMPI (Hathaway & McKinley, 1943; Lie, L; Infrequency, F; Infrequency 1 subscale, F1; Infrequency 2 subscale, F2; and Defensiveness, K), help to detect deviant test-taking attitudes and responses of adolescents. The Variable Response Inconsis- tency (VRIN) and True Response Inconsistency (TRIN) scales are additional validity scales that inform about the consistency of responses to the items. With regards to the clinical scales (Hypochondriasis, Hs; Depression, D; Hysteria, Hy; Psycho- pathic Deviate, Pd; Masculinity-Femininity, Mf; Paranoia, Pa; Psychasthenia, Pt; Schizophrenia; Sc; Hypomania, Ma; and Social Introversion, Si), the revision from the MMPI to the MMPI–A basically maintained the same items of the original instrument, with the exception of Mf and Si. Six supple- mentary scales were also included (MacAndrew Alcoholism Scale–Revised, MAC–R; Alcohol/Drug Problem Acknowl- edgment, ACK; Alcohol/Drug Problem Proneness, PRO; Immaturity, IMM; Welsh’s Anxiety, A; and Repression, R),

Received November 20, 2008; Revised April 15, 2010. Address correspondence to José Marı́a Salinas, Facultad de Psicologı́a, Uni-

versidad de Granada, 18071 Granada, Spain; Email: [email protected]

and 15 content scales were introduced (Adolescent-Anxiety, A-anx; Adolescent-Obsessiveness, A-obs; Adolescent- Depression, A-dep; Adolescent-Health Concerns, A-hea; Adolescent-Alienation, A-aln; Adolescent-Bizarre Mentation, A-biz; Adolescent-Anger, A-ang; Adolescent-Cynicism, A- cyn; Adolescent-Conduct Problems, A-con; Adolescent-Low Self-Esteem, A-lse; Adolescent-Low Aspirations, A-las; Adolescent-Social Discomfort, A-sod; Adolescent-Family Problems, A-fam; Adolescent-School Problems, A-sch; and Adolescent-Negative Treatment Indicators, A-trt).

The item changes of the MMPI–A were made by the steer- ing committee responsible for the creation of the revised test booklet to improve the content and the relevance of some items in the experiences of adolescents’ lives. Archer and Gordon (1994) evaluated the impact of these changes. They examined the psychometric stability of the modifed items using test–retest correlations in a sample of 265 adolescents ages 13 to 17 years, and found that the modifed items did not lead to any relevant changes in response patterns compared to those on the MMPI.

Correlations between the basic scales of the original MMPI have been studied in samples of adolescent inpatients by Archer, Ball, and Hunter (1985), Archer and Gordon (1988), Archer, Gordon, Anderson, and Giannetti (1989), Ball, Archer, Struve, Hunter, and Gordon (1987), and Williams and Butcher (1989). Butcher et al. (1992) reported the reliability of MMPI–A clinical scale scores as ranging from .65 to .84 in a normative sample of English-speaking adolescents (45 boys and 109 girls). These values were similar to the test–retest correlation values for adults presented in the MMPI–2 (Minnesota Multiphasic Personality Inventory–2; Butcher, Dahlstrom, Graham, Telle- gen, & Kaemmer, 1989) manual. Internal consistency values (Cronbach’s alpha) of the MMPI–A validity and clinical scales

26

27 MMPI–A SPANISH VERSION RELIABILITY AND VALIDITY

in the normative sample of English-speaking boys and girls were high for many scales (for example, Hs and Sc had an inter- nal consistency of .78–.79 and .88–.89, respectively). Yet, the coeffcients obtained for other scales such as Mf and Pa in the same English-speaking sample were relatively low or moderate (.40–.43 and .57–.59, respectively; Butcher et al., 1992).

The construction of scales focused on item content, such as the MMPI–A content scales, has received increasing acceptance over the last 30 years (Burisch, 1984; Jackson, 1971). Such scales have proven to be as good at describing and predicting personality variables as those created using other methods (Hase & Goldberg, 1967). Moreover, their homogeneity makes them easy to interpret (Burisch, 1984). The internal consistency of the MMPI–A content scales was acceptable, both in the norma- tive sample (α = .55–.83) and the clinical sample (α = .63–.83), and test–retest correlations ranged between .62 and .82 (Butcher et al., 1992). McGrath, Pogge, and Stokes (2002) studied the in- cremental validity of the content scale scores when added to the clinical scales of the MMPI–A as predictors of various be- havioral disorders in a sample of adolescents of both sexes. They found that the content scales offered incremental validity over the clinical scales and supported the use of the content scales as an adjunct to the traditional clinical scales. Forbey and Ben-Porath (2003) reported that several of the MMPI–A content scales show signifcant incremental validity in predicting behav- ior and personality characteristics of adolescents. The clinical scales also demonstrated incremental validity in reference to the content scales, indicating that the two sets of scales provide complementary information.

Because personality traits are expected to remain stable over time, scores from instruments aimed at measuring such traits should also remain very stable. Stability is usually assessed by measuring the correlation between scores obtained in the same test at two different points in time or scores obtained from paral- lel forms of the same test. To estimate the reliability coeffcient with the test–retest procedure, it is necessary to calculate the Pearson product–moment correlation coeffcient between the two sets of scores of the same individuals on two occasions. However, this procedure has some drawbacks: (a) Repeating the same test twice might cause the frst test to infuence the results of the second one; and (b) a short time interval between two test sessions might increase memory effects, whereas a long time interval might lead to changes in the participants’ level of information. For all these reasons, estimates made with the test–retest method are more appropriate for tests that assess traits that are not likely to be affected by the effects of practice and remain stable over the time interval in question. Informa- tion about the degree of stability of scores is essential in many applied situations.

In addition to test–retest stability, the stability of a given measure might be low because there is a broad variation in the amount of score change, or low internal consistency, across scales. These two factors of instability can be reviewed by an- alyzing the relation between the internal consistency reliability coeffcient (Cronbach’s alpha) and the test–retest reliability co- effcient through a qualitative procedure. So far, no statistic available can be calculated and function as an indicator of the type of relation between both coeffcients mentioned. If the same test is applied twice with an interval of several weeks between sessions, several scenarios could occur: Both the internal con- sistency (alpha) and the test–retest reliability coeffcient might

be high or low and confrmed in the second test, or the former might be high and the latter might be low; in the second case, the test seems to be reliable, but the trait measured in participants has changed in that time interval. Tests are meant to have a high alpha coeffcient, showing adequate internal consistency. They are also meant to show a high correlation between parallel forms applied within an interval of weeks, showing adequacy in the repeatability and stability of measures. So far, no studies have analyzed the existing relation between the test–retest reliability and internal consistency of the MMPI–A scales in the Spanish adolescent population.

The Spanish adaptation of the MMPI–A was carried out ´ by Jim´ omez Avila-Espada of the University ofenez-G´ and

Salamanca, Spain, between 1994 and 2002 and published in 2003 (Jim´ omez & ´ enez-G´ Avila-Espada, 2003); however, the au- thors did not provide any information about the reliability of the scales. No reliability coeffcients have been provided by other studies that have used Spanish versions of the MMPI–A (Scott, Butcher, Young, & Gomez, 2002; Scott & Mamani-Pampa, 2008). Given the scarcity of studies on the use of the MMPI–A with Spanish adolescents, the aim of this study was to study the test–retest reliability and internal consistency of MMPI–A scale scores among Spanish adolescents (see Carretero-Dios & P´ on, 2007, for instrumental studyerez, 2007; Montero & Le´ guidelines). External validity of MMPI–A scale scores was as- sessed through their correlations with behavioral syndrome and social interaction measures.

METHOD

Participants

All data were obtained from Spanish students ages 14 to 18 years in various secondary schools of the province of Granada, Spain. No nonstudent samples were used in this study, and par- ticipants were assessed in their school environment. Of the 26 randomly selected secondary education schools whose partici- pation was requested, only 13 agreed to participate in the study. Thus, the sample was more a convenience sample than a random sample. Participants were briefed in general terms about the pur- poses of the research and told that privacy of the data collected was guaranteed. All participants expressed their consent to par- ticipate once the conditions of the study had been explained. The assessment was carried out by a single examiner using standard instructions and guidelines to answer the questionnaires.

Two nonoverlapping samples were selected: The frst one in- cluded 939 adolescents (539 girls, 400 boys) with a mean age of 15.69 years (SD = 1.27, range = 14–18); the second sample was made up of 109 adolescents (53 girls, 56 boys) with a mean age of 15.26 years (SD = 1.12, range = 14–17). About two thirds (n = 630) of participants in the frst sample were in their second, third, or fourth year of compulsory secondary education (Educacion´ Secundaria Obligatoria); the rest were students in the frst or second year of noncompulsory secondary education (Bachillerato; n = 174) and students following various voca- tional training courses (Ciclos Formativos; n = 135) such as cooking, hairdressing, and so on.

Instruments

MMPI–A (Butcher et al., 1992). MMPI–A valid- ity, clinical, content, and supplementary scales, and subscales of the clinical scales, were examined in this study.

28 ZUBEIDAT, SIERRA, SALINAS, ROJAS-GARCIA

Youth Self-Report for Ages 11–18 (YSR; Achenbach & Rescorla, 2000, 2001). The YSR assesses adolescents’ psy- chosocial skills and problem behaviors. Verhulst, van der Ende, and Koot (1997) provided evidence of reliability and validity data. These authors reported Cronbach alpha values of .61 for boys and .67 for girls in a sample of normal adolescents (15– 18 years). Higher values were found in samples of adolescent patients: boys (.73) and girls (.70). In Spain, Lemos, Fidalgo, Calvo, and Menéndez (1992) reported that girls scored higher than boys on internalized behaviors, whereas boys scored higher on externalized behaviors. Abad, Forns, Amador, and Martorell (2000) revealed that internal consistency is higher for internal- ized and externalized syndrome scales (range = .81–.84) than narrowband ones (range = .56–.74).

Liebowitz Social Anxiety Scale (LSAS; Liebowitz, 1987). This scale includes 24 items that assess performance in so- cial situations by evaluating the degree of fear experienced and the degree of avoidance reported by participants. Cox, Ross, Swinson, and Direnfeld (1998) reported high internal consis- tency coeffcients for the social fear and social avoidance sub- scales (α = .90). In the Spanish validation, Bobes et al. (1999) obtained internal consistency coeffcient values above .73 for all the LSAS scales; the intraclass correlation coeffcients obtained in the 2-week test–retest studies featured values above .82 for all subscales.

Social Interaction Anxiety Scale (SIAS; Mattick & Clarke, 1998). The SIAS includes 20 items that are meant to be an- swered using a 5-point Likert scale. It has a high internal consis- tency (α = .93) and a 1-month test–retest correlation coeffcient above .90. Ries et al. (1998) reported that the SIAS discriminates between generalized and specifc subtypes of social phobia. In Spain, Olivares, Garcı́a-López, and Hidalgo (2001) found an internal consistency coeffcient of .89 and obtained two factors that explain 40.11% of the variance. Nevertheless, the confr- matory factor analysis supported the single-factor model and clustered all the items into a single factor called interaction social anxiety.

Social Avoidance and Distress Scale (SAD; Watson & Friend, 1969). The SAD includes 28 items, half of which refer to subjective discomfort in social situations, and the other half of which refect active avoidance of such situations. This scale has shown an internal consistency of .94 and a 1-month test–retest reliability of .68. Hoffmann, DiBartolo, Holaway, and Heimberg (2004) reported a Cronbach’s alpha of .93. In Spain, the reliability of the avoidance subscale was .87, whereas that of social anxiety was .85 (Comeche, Dı́az, & Vallejo, 1995). Garcı́a-López, Olivares, Hidalgo, Beidel, and Turner (2001) found a 10-day test–retest reliability of .85 in an adolescent sample.

Fear of Negative Evaluation Scale (FNE; Watson & Friend, 1969). The FNE assesses the degree of intensity with which individuals experience fear of being negatively evaluated by others. Watson and Friend (1969) reported an internal con- sistency coeffcient of .94 and a 1-month test–retest reliability of .78. In Spain, internal consistencies of .94 and .90 were obtained for the original and the short versions of the scale, respectively.

Garcia-López et al. (2001) reported a 10-day test–retest relia- bility of .84.

Procedure

The 939 adolescents were assessed collectively in their class- rooms in two 75-min sessions by a single examiner. The re- maining 109 adolescents were assessed in two different ses- sions separated by a 2-week interval. Data collection started once consent had been obtained from the parents and teach- ers of the adolescents and the adolescents themselves. They were all assured of confdentiality. Each session lasted for about 60 min and the MMPI–A was administered in group testing by the same examiner. The assessment of the sample of 939 ado- lescents with all measures occurred over a 4-month period, and that of the sample of 109 adolescents twice with the MMPI–A took 2 weeks. All participants were offered the opportunity to receive individual information about their results on the tests as well as their psychological interpretation.

RESULTS

The assumptions of classical test theory were tested by veri- fying whether the means and variances of the variables differed signifcantly between the frst and the second administration of the MMPI–A in the sample of 109 adolescents.

Hotelling’s T2 test for equality of means was not signif- icant for the 67 variables, with the exception of VRIN and TRIN, F (67, 32) = 1.36, p = .171. Equality of variances was tested by the Pitman–Morgan test with the Bonferroni correc- tion for the same 67 variables. No signifcant differences were obtained between variances obtained in the two administra- tions.

MMPI–A test–retest reliability coeffcients in the sample of 109 adolescents ranged from .62 (for the Ma1scale) to .92 (for the IMM scale); most correlations exceeded .70. Alpha internal consistency values were similar in both administrations of the test. Alpha and test–retest correlation values were similar in most cases; low internal consistency values and high test–retest correlations were only obtained for 18 scales (see Table 1).

The internal consistency of both administrations of the MMPI–A in the sample of 109 adolescents was also calculated. As shown in Table 1, pretest and posttest alpha values in this sample were very similar to those obtained in the initial sample of 939 adolescents.

Analysis of external validity data for the MMPI–A involved calculating the correlations between the basic and content scales and the common seven syndromes of the YSR/11–18 found in both boys and girls in the factorial study of Zubeidat, Fernández- Parra, Salinas, and Sierra (in press) and other social anxiety mea- sures (LSAS, SIAS, SAD, and FNE). Results are shown in Ta- ble 2. Overall, correlations were moderate in size. The strongest relationships were found between MMPI–A scales assessing social introversion/discomfort and social anxiety measures, and between MMPI–A scales measuring anxiety and depres- sion and the Anxious/Depressed scale of the YSR/11–18 (see Table 2).

DISCUSSION

As discussed by Archer (2005), the MMPI and the MMPI– A have been used in the assessment of adolescents for over 60 years, leading to more than 200 studies dealing with

29 MMPI–A SPANISH VERSION RELIABILITY AND VALIDITY

TABLE 1.—Test–retest reliability and internal consistency in both administrations of the Minnesota Multiphasic Personality Inventory–Adolescent.

Alpha of Initial Scale No. of Items Test–Retestr Pretest Alpha Posttest Alpha Sample (N = 939)

Variable Response Inconsistency (VRIN) 50 .80 .43 .74 .60 True Response Inconsistency (TRIN) 24 .81 — — — Infrequency Subscale (F1) 34 .75 .80 .84 .81 Infrequency Subscale (F2) 33 .89 .84 .85 .83 Infrequency (F) 67 .92 .89 .91 .89 Lie (L) 14 .81 .45 .46 .58 Defensiveness (K) 30 .77 .70 .73 .65 Hypochondriasis (Hs) 31 .81 .74 .75 .71 Depression (D) 57 .74 .56 .46 .57 Hysteria (Hy) 60 .71 .53 .57 .60 Psychopathic Deviate (Pd) 48 .85 .64 .58 .54 Masculinity/Femininity-Males (Mf) 44 .74 .36 .32 .27 Masculinity/Femininity-Females (Mf) 44 .80 .24 .09 .20 Masculinity-Femininity (Mf) 44 .86 — — — Paranoia (Pa) 40 .77 .54 .55 .62 Psychasthenia (Pt) 48 .92 .85 .85 .84 Schizophrenia (Sc) 77 .90 .89 .89 .87 Hypomania (Ma) 46 .82 .69 .64 .61 Social Introversion (Si) 62 .88 .80 .77 .70 Subjective Depression (D1) 29 .76 .67 .60 .64 Psychomotor Retardation (D2) 14 .66 .21 .18 .18 Physical Malfunctioning (D3) 11 .68 .11 .34 .34 Mental Dullness (D4) 15 .79 .63 .55 .55 Brooding (D5) 10 .71 .57 .48 .62 Denial of Social Anxiety (Hy1) 6 .75 .57 .58 .56 Need for Affection (Hy2) 11 .78 .54 .63 .35 Lassitude-Malaise (Hy3) 15 .83 .61 .59 .60 Somatic Complaints (Hy4) 17 .78 .69 .67 .58 Inhibition of Aggression (Hy5) 7 .68 .15 .20 .36 Familial Discord (Pd1) 9 .80 .65 .60 .45 Authority Problems (Pd2) 8 .65 .20 .34 .22 Social Imperturbability (Pd3) 6 .83 .58 .56 .42 Social Alienation (Pd4) 12 .78 .45 .39 .50 Self Alienation (Pd5) 12 .80 .62 .61 .54 Persecutory Ideas (Pa1) 17 .78 .74 .75 .69 Poignancy (Pa2) 9 .77 .34 .36 .44 Naivete (Pa3) 9 .79 .40 .53 .49 Social Alienation (Sc1) 21 .80 .65 .72 .68 Emotional Alienation (Sc2) 11 .83 .52 .43 .56 Lack of Ego Mastery-Cognitive (Sc3) 10 .84 .68 .60 .60 Lack of Ego Mastery-Conative (Sc4) 14 .80 .54 .58 .56 Lack of Ego Mastery-Defective Inhibition (Sc5) 11 .81 .61 .63 .60 Bizarre Sensory Experiences (Sc6) 20 .82 .77 .75 .70 Amorality (Ma1) 6 .62 .14 .16 .18 Psychomotor Acceleration (Ma2) 11 .79 .49 .49 .40 Imperturbability (Ma3) 8 .76 .40 .52 .12 Ego Infation (Ma4) 9 .74 .49 .45 .43 Shyness/Self-Consciousness (Si1) 14 .86 .75 .74 .66 Social Avoidance (Si2) 8 .82 .61 .61 .55 Alienation-Self and Others (Si3) 17 .82 .74 .69 .70 MacAndrew Alcoholism Scale-Revised (MAC-R) .49 .78 .38 .54 .46 Alcohol/Drug Problem Acknowledgment (ACK) 13 .88 .65 .66 .62 Alcohol/Drug Problem Proneness (PRO) 36 .85 .50 .45 .48 Immaturity (IMM) 43 .92 .83 .81 .75 Welsh’s Anxiety (A) 35 .90 .84 .81 .84 Repression (R) 33 .81 .51 .53 .61 Adolescent-Anxiety (A-anx) 21 .90 .75 .74 .67 Adolescent-Obsessiveness (A-obs) 15 .82 .63 .61 .67 Adolescent-Depression (A-dep) 26 .86 .78 .76 .78 Adolescent-Health Concerns (A-hea) 37 .86 .84 .83 .77 Adolescent-Alienation (A-aln) 20 .88 .71 .75 .70 Adolescent-Bizarre Mentation (A-biz) 19 .87 .81 .82 .74 Adolescent-Anger (A-ang) 17 .85 .71 .71 .66 Adolescent-Cynicism (A-cyn) 22 .86 .74 .78 .69 Adolescent Conduct Problems (A-con) 23 .89 .68 .74 .70 Adolescent-Low Self-Esteem (A-lse) 18 .86 .66 .63 .65 Adolescent-Low Aspirations (A-las) 16 .85 .65 .59 .44 Adolescent-Social Discomfort (A-sod) 24 .91 .77 .76 .71 Adolescent-Family Problems (A-fam) 34 .90 .86 .84 .78 Adolescent-School Problems (A-sch) 20 .83 .66 .66 .63 Adolescent-Negative Treatment Indicators (A-trt) 26 .86 .75 .77 .70

30 ZUBEIDAT, SIERRA, SALINAS, ROJAS-GARCIA

TABLE 2.—Pearson’s correlations between Minnesota Multiphasic Personality Inventory–Adolescent clinical and content scales and Youth Self-Report for Ages 11–18 scales and social anxiety measures.

Scale A/D DB AB SC THP RP AP LSAS SIAS SAD FNE

Infrequency Subscale (F1) .14** .29** .08* −.02 .23** −.10** .16** .01 .09** .16** .02 Infrequency Subscale (F2) .18** .22** .10** .04 .25** −.02 .15** .13** .16** .23** .08* Infrequency (F) .17** .28** .10** .01 .27** −.06 .17** .08* .14** .22** .06 Lie (L) −.28** −.27** −.32** −.18** −.27** −.21** −.27** −.20** −.12** −.06 −.10** Defensiveness (K) −.43** −.32** −.41** −.33** −.38** −.29** −.33** −.32** −.28** −.26** −.25** Hypochondriasis (Hs) .26** .21** .17** .28** .23** −.01 .12** .14** .20** .29** .20** Depression (D) .29** .01 .01 .05 .06 .06 −.08* .17** .32** .34** .31** Hysteria (Hy) .11** .06 .01 .10** .04 −.16** −.05 −.04 .01 .08* .06 Psychopathic Deviate (Pd) .38** .38** .28** .14** .33** −.00 .24** .11** .13** .20** .15** Masculinity-Femininity (Mf) .20** −.05 .12** .13** .00 .03 −.09* .06 .11** .01 .21** Paranoia (Pa) .28** .23** .15** .11** .24** −.05 .13** .08* .17** .23** .21** Psychasthenia (Pt) .54** .36** .36** .35** .43** .28** .31** .38** .39** .41** .36** Schizophrenia (Sc) .37** .37** .27** .21** .41** .09** .30** .21** .25** .33** .19** Hypomania (Ma) .17** .37** .26** .16** .33** −.03 .31** .04 −.01 −.01 −.02 Social Introversion (Si) .38** .15** .14** .15** .17** .35** .13** .43** .54** .60** .41** Welsh’s Anxiety (A) .55** .33** .36** .37** .41** .31** .31** .42** .42** .40** .39** Repression (R) −.19** −.30** −.28** −.21** −.31** −.13** −.32** −.14** .01 .03 −.01 Adolescent-Anxiety (A-anx) .49** .35** .36** .37** .41** .21** .29** .32** .30** .34** .33** Adolescent-Obsessiveness (A-obs) .41** .31** .36** .33** .36** .28** .32** .33** .32** .30** .28** Adolescent-Depression (A-dep) .55** .31** .29** .24** .36** .19** .22** .28** .33** .34** .31** Adolescent-Health Concerns (A-hea) .19** .18** .13** .23** .23** −.06 .12** .10** .15** .26** .18** Adolescent-Alienation (A-aln) .39** .29** .19** .11** .31** .12** .19** .21** .32** .36** .19** Adolescent-Bizarre Mentation (A-biz) .26** .34** .22** .19** .38** .02 .29** .08* .11** .19** .06 Adolescent-Anger (A-ang) .34** .44** .49** .27** .36** .18** .36** .22** .16** .20** .16** Adolescent-Cynicism (A-cyn) .31** .28** .27** .21** .32** .15** .28** .22** .12** .14** .12** Adolescent Conduct Problems (A-con) .11** .43** .22** .10** .27** .01 .32** .06 .03 .12** −.05 Adolescent-Low Self-Esteem (A-lse) .44** .24** .20** .19** .26** .22** .20** .35** .40** .40** .33** Adolescent-Low Aspirations (A-las) .13** .17** .12** .03 .10** .03 .10** .07* .15** .19** .07* Adolescent-Social Discomfort (A-sod) .19** .09** −.01 .00 .06 .23** .04 .30** .46** .53** .23** Adolescent-Family Problems (A-fam) .28** .36** .27** .09** .34** .02 .26** .09** .13** .17** .08* Adolescent-School Problems (A-sch) .20** .44** .23** .12** .27** .06 .22** .11** .09** .14** .04 Adolescent-Negative Treatment Indicators (A-trt) .38** .30** .24** .17** .32** .23** .25** .34** .34** .37** .21**

Note. A/D = Anxious/Depressed; DB = Delinquent Behavior; AB = Aggressive Behavior; SC = Somatic Complaints; THP = Thought Problems; RP = Relational Problems; AP = Attention Problems; LSAS = Liebowitz Social Anxiety Scale; SIAS = Social Interaction Anxiety Scale; SAD = Social Avoidance and Distress Scale; FNE = Fear of Negative Evaluation Scale. ∗ p < .05. **p < .01.

adolescent samples. Such studies have made important con- tributions not only to the study of the psychometric charac- teristics of these instruments, but also to our understanding of the development and psychopathology of adolescents. How- ever, the characteristics of these tools have not been suff- ciently studied in certain adolescent populations. For example, Perfect (2005) pointed out that there are still limited em- pirical data to support the clinical use of the MMPI–A in samples of abused adolescents. Similarly, no studies so far have explored the test–retest reliability and the internal con- sistency of the scales of the MMPI–A in the Spanish adolescent population.

The design of studies with the objectives just mentioned often involves working with two samples: The frst one was a large reference sample with participants assessed in one session, and the second and smaller sample was assessed twice with the same test, with a 2-week time interval between administrations. To estimate the reliability coeffcient with the test–retest method, the test should measure traits that are not likely to be affected by the effects of practice and remain stable over the time interval in question. Thus, it is necessary to verify the stability of the score distribution beforehand. Results of this study showed no overall differences between the means of the frst and second administration of the MMPI–A scales; results of the multivariate difference of means test were clearly not signifcant. Likewise,

no signifcant differences were found in the variances of both administrations of the MMPI–A.

With regard to test–retest reliability, correlations between both administrations of the MMPI–A scales were high and were considered satisfactory. In fact, most of these correlations ex- ceeded .70 and ranged between .62 and .92. These results are similar to those found by P´ ıas, Dur´ omez-erez y Far´ an, and G´ Maqueo (2003) in a sample of 1,056 Mexican adolescents, where test–retest correlations were statistically signifcant with values ranging between .36 and .90. They also agree with those obtained by Butcher et al. (1992), which ranged between .47 and .84 in a sample of American adolescents. P´ ıaserez y Far´ et al. (2003) concluded that the clinical, validity, content, and supplementary scales of the MMPI–A were stable in their sam- ple of adolescents, like other studies (Aharoni, 1999; Ampudia, Duran, & Lucio, 1995; Gomez, Johnson, Davis, & Velazquez, 2000; Hammel, 2001; Mendoza-Newman, 2000; Sirigati, 2000), including this one. Moreover, alpha values were very simi- lar across the pretest and posttest. Along these lines, Carlson and Hofstra (2001) carried out a study in which 80 adoles- cents between the ages of 14 and 18 completed a computerized and a written version of the MMPI–A (with a 1-week interval between both counterbalanced sessions); results showed that the clinical, content, and supplementary scales and the test– retest correlation coeffcients were statistically signifcant and

31 MMPI–A SPANISH VERSION RELIABILITY AND VALIDITY

compared favorably with the reliability data provided in the MMPI–A manual. Results from Stein, McClinton, and Gra- ham’s (1998) study examining the long-term stability of the clinical, content, and supplementary scales and the MMPI–A personality psychopathology scales in a sample of 61 adoles- cents were also consistent with the fndings of MMPI–A score reliability reported earlier. Moreover, improvements shown dur- ing the development of the MMPI–A have led to moderate in- creases in the stability of the clinical scales in adolescents.

Findings on internal consistency values and test–retest cor- relation showed that both coeffcients were similar, and could therefore be viewed as jointly providing evidence of suffcient consistency as well as stability in responses to the items. In fact, Vinet and Alarcon´ (2003) studied a sample of 705 Chilean adolescents and reported that the MMPI–A is a stable and con- sistent measure, with similar reliability levels (stability and in- ternal consistency) to those obtained in studies carried out in other countries. Low internal consistency and high test–retest correlations were only obtained in a few scales of this study, demonstrating the overall stability of responses to the items. However, the inadequate internal consistency of these scales shows that they need to be reviewed. Problems related to lack of internal consistency cannot be attributed to sample size, because values in the smaller sample of 109 adolescents were very sim- ilar to those obtained in the sample of 939 adolescents. We also studied the external validity of the clinical and content MMPI–A scales based on their correlation with other variables related to adolescents’ behavioral problems and social discomfort. Over- all, most of these correlations were signifcant and moderate in size, and in the expected direction. In general, MMPI–A scales that assess internalized problems showed higher corre- lations with YSR/11–18 scales that assess such problems than with those assessing externalized problems; conversely, scales that assess externalized problems show higher correlations with YSR/11–18 scales related to externalized problems rather than internalized ones. These results are similar to those found in other MMPI–A studies with clinical samples. Indeed, Butcher et al. (1992) reported similar correlations between the clinical scales and the Child Behavior Checklist in the MMPI–A manual. More recently, Veltri et al. (2009) obtained similar results with psychiatric and forensic samples by correlating the MMPI–A scales with criterion variables using a standardized Record Re- view Form; the study by Stokes, Pogge, Sarnicola, and McGrath (2009) in an adolescent inpatient psychiatric sample showed a similar trend.

Nevertheless, the highest correlations were only found be- tween MMPI–A social interaction scales and social anxi- ety variables and between MMPI–A anxiety and depression scales and the anxious/depressed syndrome. Likewise, Mennin, Heimberg, and Jack (2000) reported that individuals with patho- logical levels of social anxiety show high scores of social anxiety and avoidance, general anxiety, cognitive symptoms of anxiety, and depressive mood. Also, Heimberg et al. (1999) found that total anxiety and avoidance scores highly correlated with total fear and total avoidance (.90 for both); these authors reported that the correlations found between total anxiety and avoidance and other measures of anxiety tend to be higher than those found between the former and measures of depression, as happened in this study. Along these lines, Zubeidat, Salinas, and Sierra (2008) reported that total anxiety and avoidance scores showed higher correlations with measures of social anxiety (e.g., SIAS,

FNE, and SAD) than with variables related to MMPI–A depres- sion scales (e.g., Depression-D and Depression-DEP). Overall, the strongest support in this study is found for MMPI–A scales related to depression, anxiety, and social discomfort.

Limitations

This study does not include a sample of adolescents not at- tending school, which limits the possibilities of generalizing the results beyond the population of adolescent students. In Spain, education is compulsory until the age of 16, and there are very few adolescents not attending school or marginalized in the age range between 16 and 18 years. Also, participants in this study do not represent a strictly random sample because they were selected by convenience sampling. The results therefore cannot be considered representative of the Spanish adolescent population, and further study in clinical adolescent samples is certainly needed. A fnal drawback is the fact that the stability of the measures of the MMPI–A was only studied with a test–retest analysis of two points in time.

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