LORANDOS: Doctor, National Computer Systems offers a well-recognized computerized scoring system for the MCMI, correct?
Witness: Correct.
LORANDOS: I would like you to consider the disclaimer prefacing all computerized interpretations of the MCMI-II written by National Computer Systems, and I"ll read, "The MCMI reports our normal patients who were in the early phases of assessment for psychotherapy because of emotional discomforts or social difficulties. Respondents who did not fit this normative population or who have inappropriately taken the MCMI for nonclinical purposes may have distorted reports." Now my question; unless someone is in the early phases of assessment or psychotherapy because of emotional discomforts or social difficulties, it is inappropriate to use the Millon Clinical Multiaxial Inventory on that person, correct?
Witness: Well, in terms of the computerized interpretation it may be inappropriate.
LORANDOS: And the disclaimer continues, "To optimize clinical utility, the report highlights pathological characteristics and dynamics rather than strengths and positive attributes." Now my question; if the Millon Clinical Multiaxial Inventory highlights pathological characteristics rather than strengths and positive attributes, if a person taking the MCMI can be characterized as drawn from a normal population, your relying on the MCMI in this case could misinform and mislead this proceeding, correct?
Witness: It could discounting my own clinical judgment, yes.
LORANDOS: Ok and the disclaimer in the manual published by the National Computer Systems further says, "This focus should be kept in mind by the referring clinician reading the report." Now my question; you would agree with this portion of the test publisher"s disclaimer, correct?
Witness: Yes.
LORANDOS: If the examinee in this case does not necessarily exhibit emotional discomforts and social difficulties, then the use of the MCMI-II would be inappropriate, correct?
Witness: It could be.
LORANDOS: And using the MCMI to assess someone who does not necessarily exhibit emotional discomforts and social difficulties is inappropriate because the MCMI "highlights pathological characteristics and dynamics rather than strengths and positive attributes," correct?
Witness: that's true, the computerized narrative.
LORANDOS: Thank you. Therefore using the MCMI with someone who does not necessarily exhibit "emotional discomforts and social difficulties," could lead to over diagnosis of psychopathology, correct?
Witness: Yes if one over-relies on the computerized narrative.
LORANDOS: Thank you. Now the Journal of Personality Assessment is a generally recognized and accepted peer review journal in your field, correct?
Witness: Yes.
LORANDOS: And a 1996 article, by Retzlaff, published in the Journal of Personality Assessment, titled, MCMI-II Validity: Bad Test or Bad Validity, might be relevant to your opinions in this case, correct?
Witness: It could be.
LORANDOS: The positive predictive power of any test corresponds to whether an elevated score accurately identifies a particular disorder, correct?
Witness: Yes.
LORANDOS: Would it surprise you to know that Retzlaff reported the positive predictive power of the MCMI for identifying various personality disorders ranged from .07 to .32?
Witness: Yes, that would surprise me.
LORANDOS: A range of positive predictive power from .07 to .32 is pretty low isn't it doctor?
Witness: Yes.
LORANDOS: In fact, flipping a coin would give us .5 wouldn"t it?
Witness: Yes.
LORANDOS: Would it surprise you to know that in his 1996 article, Retzlaff also reported that elevated MCMI scores result in mistaken diagnosis in more than four out of five cases?
Witness: Yes I find that very surprising.
LORANDOS: That is surprising isn't it? In other words the rate of classification error when relying on elevated MCMI scores to identify personality disorders exceeds 80%, correct?
Witness: According to that data that you're citing.
LORANDOS: And you have not published anything in a peer review journal necessitating that we reconsider Retzlaff"s findings, correct?
Witness: No.
LORANDOS: And you cannot cite anything published in a peer review journal necessitating that we reconsider Retzlaff"s findings, can you?
Witness:, No.
LORANDOS: Now the journal, Law and Human Behavior is also a generally recognized and accepted peer review journal in your field, correct?
Witness: Yes it is.
LORANDOS: And a 1999 article by Rogers and his colleagues published in Law and Human Behavior, titled, Validation of the Milan Clinical Multiaxial Inventory for Axis II Disorders: Does it meet the Daubert Standard, might be relevant to your opinions in this case, correct?
Witness: It could be.
LORANDOS: And in this 1999 article in Law and Human Behavior, Rogers and his colleagues wrote, "In the current paper, we first examined the scientific evidence for the validity of the most current version, MCMI-III, for Axis II disorders and found it markedly deficient with respect to both criterion related and construct validity." Now my question; axis II disorders refer to DSM-IV classification"s personality disorders, correct?
Witness: Correct.
LORANDOS: And if the criterion related and the construct validity of the MCMI are deficient for the identification of Axis II disorders, then your relying on the MCMI-III in this case could misinform and mislead this proceeding, correct?
Witness: If that's the case, yes.
LORANDOS: You have not published anything in a peer review journal necessitating that we reconsider the 1999 position of Rogers and his colleagues regarding the MCMI-III, have you?
Witness: No.
LORANDOS: And you cannot cite anything published in a peer review journal necessitating that we reconsider the 1999 position of Rogers and his colleagues regarding the MCMI-III, correct?
Witness: No, but I can tell you that many of my colleagues, including myself, have come to rely on.
LORANDOS: Thank you, but you have not and you cannot cite, as you sit here today, anything published in a peer review journal necessitating that we reconsider the 1999 position of Rogers and his colleagues, correct?
Witness: No.
LORANDOS: Thank you doctor.