Psychological Assessment In the public domain

1995, Vol. 7, No. 4. 424-431

An MMPI-2 Infrequent Response Scale for Use With

Psychopathological Populations: The Infrequency-
Psychopathology Scale, F(p)
Paul A. Arbisi Yossef S. Ben-Porath
Veterans Affairs Medical Center, Minneapolis Kent State University

This article describes the development and initial validation of a new Minnesota Multiphasic Per-
sonality Inventory—2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B.
Kaemmer, 1989) scale designed to detect infrequent responding in settings characterized by rela-
tively high base rates of psychopathology and psychological distress. The Infrequency-Psychopathol-
ogy Scale, F(p), was developed by identifying a set of 27 MMPI-2 items answered infrequently by
both inpatients and the MMPI-2 normative sample. The new scale's construct validity was exam-
ined through tests of a series of hypotheses derived from an analysis of the reasons for elevated
Infrequency (F) and Infrequency-Back (Fb) scores in inpatient settings. The F(p) scale's incremen-
tal validity was explored by comparing its performance to that of the F scale. The results of this study
suggest that F(p) may be used as an adjunct to F in settings characterized by relatively high base
rates of psychopathology and psychological distress.

An important feature contributing to the clinical usefulness
of the Minnesota Multiphasic Personality Inventory—2
(MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaem-
mer, 1989) is the availability of scales that assess the validity
of individual test protocols. The importance of appraising the
validity of individual test scores was recognized by Hathaway
and McKinley (1943), who included two validity scales, Lie
(L) and Infrequency (F) in the original version of the MMPI.
The F scale was developed as an infrequent-response indicator
by identifying 64 items that were answered infrequently in the
keyed direction by the sample of original "Minnesota normals"
(Meehl & Hathaway, 1946). Items included in the Fscale were
also selected to cover a variety of content so that it would be
unlikely that any particular set of problems would produce an
elevated score on the F scale (Meehl & Hathaway, 1946).
Hathaway and McKinley originally intended the F scale to be
used for the identification of recording and scoring errors of
respondents who could not read or comprehend the test items
and of individuals who did not cooperate sufficiently with the
testing procedure (Meehl & Hathaway, 1946). However, it was
discovered early that F was also sensitive to intentional attempts
to portray oneself in an overly negative manner (Meehl &
Hathaway, 1946), a test-taking approach that has been termed
We thank Jack Graham and Jim Butcher for permission to use their
psychiatric inpatient sample in this study, Jack Graham and Rodney
Timbrook for permission to use their fake-bad sample in this study,
Kristen Shepherd for her assistance with data management and analy-
sis, and Jack Graham and Auke Tellegen for their helpful comments on
a previous version of this article.
Correspondence concerning this article should be addressed to Paul
A. Arbisi, Psychology Service 116B, Veterans Affairs Medical Center, 1
Veterans Drive, Minneapolis, Minnesota 55417 or Yossef S. Ben-Por-
ath, Department of Psychology, Kent State University, Kent, Ohio
44242.
424
faking bad. Thus, researchers have been aware of the multifac-
eted nature of the Fscale since its initial development.
In revising the MMPI, Butcher et al. (1989) sought to maintain
continuity with the original version of the inventory by minimiz-
ing changes on the original validity and clinical scales and by in-
troducing innovation to the MMPI-2 by developing new scales.
Consequently, the original F scale was left virtually unchanged in
composition on the MMPI-2 (losing only four objectionable
items), and a new scale, Infrequency-Back (Fb), designed to iden-
tify infrequent responding to items in the second half of the book-
let, was introduced. Although the Fb scale is not used to evaluate
the validity of an entire MMPI-2 protocol, it is recommended for
use in determining the validity of scores on the MMPI-2 Content
Scales (Butcher, Graham, Williams, & Ben-Porath, 1990) because
these scales contain many items that appear in the second half of
the booklet. Research with the MMPI-2 has shown that both F
and Fb function in the same way in the MMPI-2 as did F in the
original MMPI (cf. Graham, 1993).
Continuity between the MMPI and MMPI-2 is important be-
cause it ensures MMPI-2 users that knowledge based on the orig-
inal version of the MMPI carries over to the revised inventory.
However, this means that some problematic aspects of the original
version may also be transferred. One such area involves the pre-
viously noted multifaceted nature of scale F(and now also Fb).
Clinicians who use the MMPI-2 with individuals experiencing se-
vere distress or psychopathology are well aware of the prevalence
of highly elevated Fand Fb scores in this population. As a result,
the use of traditional cutoff scores for the identification of invalid
protocols based on F and Fb is problematic. Graham, Watts, and
Timbrook (1991) found that to discriminate between psychiatric
inpatient profiles and scores generated by individuals who were
instructed to fake bad, it is necessary to rely on F raw scores that
exceed a T score of 120. In contrast, much lower T scores are
required to discriminate between those who fake bad and individ-
 THE F(p) SCALE
uals who take the MMPI-2 under standard conditions in nonclin-
ical settings (Graham, Watts, & Timbrook, 1991).
There are, essentially, three non-mutually-exclusive reasons
why an individual may produce an elevated score on the F or Fb
scales: (a) random responding, which may be the result of nonco-
operation or an inability to read and comprehend the test items;
(b) faking, an intentional attempt to portray oneself in an overly
negative manner; and (c) psychopathology, an elevation on Fthat
reflects the presence of significant psychological distress or symp-
toms of severe psychopathology.
With the publication of the MMPI-2 and introduction of the
new consistency scale Variable Response Inconsistency (VRIN),
the task of identifying elevated F and Fb scores that are a func-
tion of random responding has been facilitated considerably.
VRIN is a very good indicator of random responding (Berry,
Baer, and Harris, 1991). However, confounding of faking and
psychopathology remains a critical problem in the interpreta-
tion of scores on F and Fb, particularly in settings in which
there is a high base rate of psychopathology. Our goal in this
study was to develop a new MMPI-2 infrequent-response scale
in which the confounding of faking and psychopathology would
be minimized. In contrast to F and Fb, whose items were se-
lected by identifying infrequently endorsed items in a nonclini-
cal sample, we developed the new Infrequency-Psychopathology
scale, F(p), by identifying items that are endorsed infrequently
in both clinical and nonclinical samples.
This article describes the development and initial validation
of F(p), including, most importantly, its incremental validity.
Based on a rational analysis of the required characteristics of an
infrequent response scale that would be less confounded with
psychopathology, we derived the following list of criteria for ex-
amining the validity of such a scale. First, if it is less sensitive to
psychopathology than F and Fb, we would expect lower T scores
on F(p) than on the other two scales in clinical samples. We
would also expect that the use of traditional T-score cutoffs on
F(p) would single out fewer protocols as invalid than when the
same cutoffs are applied to F and Fb. Second, we would expect
that correlations between F(p) and MMPI-2 measures of psy-
chopathology and distress would be lower than correlations be-
tween F and Fb and these measures. Third, we would expect
that clinical participants would score higher on Fthan nonclin-
ical participants and that there would be less of a difference be-
tween these two populations on F(p). We would also expect
to find more of a difference between psychiatric patients and
individuals faking bad on F(p) than on F. Finally, we would
expect that F(p) would add incrementally to F in discriminat-
ing between psychiatric patients and participants instructed to
fake bad on the MMPI-2.' Taken together, these criteria address
the construct and incremental validity of the F(p) scale.
In this article, then, we illustrate the problem of elevated F
and Fb scores in populations with a high base rate of psychopa-
thology; we describe the development of a new MMPI-2 scale,
F(p), designed to address this problem; and we present data
on the validity of F(p) addressing the criteria that were just
outlined.
Method
Participants
Three data sets were used in the analyses reported in this study. The
primary data set consisted of a sample of 706 men who were psychiatric
425
inpatients at a veterans affairs (VA) medical center. This sample was
composed originally of 747 men who were administered an MMPI-2
as part of the standard intake procedures at the veterans affairs hospital.
Patients were excluded from the sample if they omitted more than 15
items, or received a T score of 80 or greater on VRIN or of 100 or greater
on True Response Inconsistency (TRIM).2 A total of 41 individuals
(5.5%) met one or more of these criteria, resulting in a final sample of
706 men. Participants' mean age was 47.7 (SD = 13.1, range 18-83)
years. Racial data were not available for the entire sample; however, in a
representative subsample of 139 of the VA patients, 92.8% were Cauca-
sian; 5% African Americans, 1.4%, Hispanic, and 0.8% had a different
or an unknown ethnic origin. The most prevalent (non-mutually-
exclusive) diagnoses in this subsample were 31.6% major depression,
22.3% substance abuse, 17.2% schizophrenia, 12.2% anxiety disorders,
and 9.3% post-traumatic stress disorder.
A second data set was collected by Graham and Butcher (1988). This
set consists of 423 psychiatric inpatients. Patients were tested at three
hospitals, one a state psychiatric hospital that treated primarily chronic
psychiatric patients and two acute care psychiatric inpatient units.
There were 211 men and 178 women in this sample who met the inclu-
sion criteria just outlined for the VA sample. Participants' mean age was
32.29 (SD = 11.64, range 16-85) years. The majority of the partici-
pants were Caucasian (83.5%), followed by African-Americans (8.2%),
Native Americans (4.4%), other (2.6%), Asians (0.5%), Hispanics,
(0.3%), and 0.5% did not report their ethnic group membership. The
most prevalent diagnoses in this sample were major depression
(21.1%), schizophrenia (15.7%), bipolar disorder (10%), adjustment
disorder (10%), chemical dependency (8.2%), and schizoaffective dis-
order (6.9%).
A third data set was collected by Graham et al. (1991) and consisted
of 50 college students who participated in a study in return for extra
credit in a general psychology course. These participants were predom-
inantly Caucasians (approximately 95%) with a small proportion of Af-
rican Americans. Participants' mean age was approximately 19 years.
Instruments and Procedure
Participants in the VA sample completed the MMPI-2 using an on-
line computerized administration procedure that is used throughout
the VA system. Standard administration instructions were given to these
participants. MMPI-2s were administered as part of the standard in-
take procedure at this hospital.
Participants in the Graham and Butcher (1988) sample completed
the experimental version of the MMPI, the MMPI-AX (Butcher et al.,
1989), which was used to develop the MMPI-2, as did all participants
in the normative sample. It has also been used in studies of clinical
samples (e.g., Ben-Porath, Butcher, & Graham, 1991). This 704-item
version includes the 567 items that make up the MMPI-2. All partici-
pants were given standard administration instructions. Participants at
the acute care facilities completed the MMPI-2 as part of their intake
procedure, and participants at the state psychiatric hospital were re-
cruited to participate in the Graham and Butcher (1988) study and
were paid $4 for their participation.
Participants in the Graham et al. (1991) data set completed the paper
and pencil version of the MMPI-2 twice, with a 1-week interval, once
under standard administration procedures and another time with the
following instructions:
1
For the last three criteria, hypotheses are limited to the F scale, and
not Fb, because the latter is not typically used to address the validity of
an entire protocol.
2
A more conservative cutoff for invalidity on TRIN was used because
there are fewer empirical studies on optimal cutoff scores available for
this scale than there are for VRIN.
426 ARBISI AND BEN-PORATH

Table 1 Table 2
Means, Standard Deviations, and Frequencies off and Fb for Endorsement Frequencies of Select F Scale Items in the
the VA Sample Veterans Affairs (VA; n = 706) and MMPI-2 Normative
(Norm; n = 1,138) Samples
Scores (%)
Item
Scale M SD >90 >100 120 No. MMPI-2 item VA Norm
F 77.3 22.8 29.3 19.5 13.2 7.2 12 My sex life is satisfactory. (F) 65 27
Fb 85.6 25.2 43.9 32.7 25.6 19.4 264 I have used alcohol excessively. (T) 63 44
180 There is something wrong with my mind. (T) 52 5
Note. N = 706. The Veterans Affairs (VA) sample consisted of psychi- 168 I have had periods in which I carried on activities 47 9
atric inpatients at a VA medical center. Percentages are cumulative (i.e., without knowing later what I had been doing.
the 19.5% who scored above 100 of Fare included among the 29.3% (T)
who scored above 90 on this scale. F = Infrequency scale; Fb = Infre- 30 I have nightmares every few nights. (T) 44 6
quency-Back scale of the Minnesota Multiphasic Personality Inven- 306 No one cares much what happens to you. (T) 41 13
tory—2. 330 At times I am all full of energy. (F) 40 9
84 I was suspended from school one or more times 39 17
for bad behavior. (T)
48 Most anytime I would rather sit and daydream 38 12
This is the Minnesota Multiphasic Personality Inventory, Revised than do anything else. (T)
(MMPI-2). In responding to the items in the inventory, please try 204 My hearing is apparently as good as that of most 35 19
to answer in the way that you think one would answer if he or she people. (F)
were wanting to give the impression of being a person who has very Note. Numbers are percentages of participants in each sample an-
serious psychological or emotional problems. swering in the keyed direction. Scoring key follows each item in paren-
theses (T = true; F = false). Minnesota Multiphasic Personality Inven-
The order of the two conditions was counterbalanced such that roughly tory—2 (MMPI-2) items and scoring direction of items reprinted from
half of the sample completed the MMPI-2 under standard instructions MMPI-2: Manual for Administration and Scoring by J. N. Butcher,
the first time and the remaining participants completed the inventory W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989,
under fake-bad instructions the first time. Minneapolis, MN: University of Minnesota Press. Copyright 1942,
1943, 1951, 1967 (renewed 1970), 1989, and 199 5 by the Regents of the
University of Minnesota. Reproduced by permission of the University
Results of Minnesota.
The results of this study are reported in several sections. First,
we illustrate the problem of elevated F and Fb scores in inpa-
tient samples and explore its likely cause. Next, we describe the These findings have two possible explanations. Either a sig-
development of the F(p) scale and report the results of analyses nificant proportion of VA inpatients produces uninterpretable
that compare the new scale with the F and Fb scales to deter- profiles, or the standard used to determine invalidity is some-
mine whether it functions as intended. Finally, we describe anal- how inappropriate for this population. To explore the latter pos-
yses that test the construct validity and incremental validity of sibility, we computed item endorsement frequencies for all F
the F(p) scale. and Fb items in the VA inpatient and MMPI-2 normative sam-
ples. Items with the greatest endorsement frequencies on F and
Illustration and Explanation of Elevated F and Fb Fb are presented in Tables 2 and 3, respectively.
Examination of the item endorsement frequencies in Table 2
Scores in an Inpatient Sample
points to two important findings. First, some F items that are
Our first set of analyses was designed to illustrate the problem intended to reflect infrequent responding are answered by more
of elevated F and Fb scores in inpatient settings. Table 1 pre- than half of the inpatient sample in the keyed direction. Exam-
sents the means, standard deviations, and percentages of partic- ination of the content of frequently endorsed F items suggests
ipants scoring above certain cutoff points on scales F and Fb in that they address problems that are not uncommon in inpatient
the VA inpatient sample of 706 men. The mean Tscore for Fin or other psychopathological samples. Although some of these
this sample falls over 2 SD above the normative mean of 50, and frequencies may be particularly elevated for VA inpatients (e.g.,
the mean T score for Fb lies over 3 SD above the norm. The the experience of nightmares), they also can be expected in
standard deviations indicate considerable variability on both other clinical samples (i.e., nightmares could also be a side
scales within this sample. effect of neuroleptic medication).
The most direct illustration of the problem of elevated F and A second important finding in Table 2 is that some F items
Fb scores among inpatients is found in the frequency data re- are not infrequent response indicators even in the normative
ported in Table 1. If one uses a more conservative cutoff of a T sample. Item selection for the F scale was done with the original
score greater than 90 on F to determine invalidity, nearly one "Minnesota normals," a sample consisting primarily of farmers
third of the sample would have produced invalid MMPI-2 pro- and rural laborers who lived in Minnesota over 50 years ago.
files. Over 40% would have uninterpretable content scales based Clearly, if a new F scale were to be constructed based on the new
on an Fb T score greater than 90. Even when less stringent rules normative sample, some of the original F items would not be
are used, nearly one fifth of the sample has F scores greater than included in this scale.
100, and one third of the sample exceeds a rscore of 100 on Fb. Table 3 indicates that many of the new Fb items are endorsed
 THE F(p) SCALE 427

Table 3 developed using the MMPI-2 normative sample, and a T-score

Endorsement Frequencies of Select Fb Items in the conversion table is presented in the Appendix.
Veterans Affairs (VA;n = 706) and MMPI-2 Normative Examination of Table 4 indicates that F(p) is made up of a
(Norm; n = 1,138) Samples heterogeneous set of items that reflect severe psychotic symp-
toms, very unusual habits, highly amoral attitudes, identity con-
Item fusion, and, interestingly, a number of items that appear on
No. MMPI-2 item VA Norm
scale L. The inclusion of items that are scored on L is consistent
517 I find it difficult to hold down a job. (T) 58 4 with clinical observations of elevations on this scale in inpa-
526 I know I am a burden to others. (T) 54 5 tients who are attempting to fake bad. Clearly, these items are
539 Lately I have lost my desire to work out my 54 6 not entirely unrelated to psychopathology or psychological dis-
problems. (T)
454 The future seems hopeless to me. (T) 51 5 tress. However, given their low frequencies of endorsement in
506 I have recently considered killing myself. (T) 49 4 inpatient samples, they are less likely to be confounded with
516 My life is empty and meaningless. (T) 45 3 these factors than are the F and Fb scales. Thus, we would ex-
525 Everything is going on too fast around me. (T) 45 7 pect that the mean F(p) score would be lower than the means
463 Several times a week I feel as if something dreadful 44 4 for F and Fb in inpatient samples and that various cutting
is about to happen. (T)
383 When things get really bad, I know I can count on 40 10 scores on F(p) would identify fewer inpatient participants as
my family for help. (F) possibly having faked bad than would comparable cutting
281 I dislike having people around me. (T) 39 5 scores on F and Fb.
311 I often feel as if things are not real. (T) 38 8 As expected, the mean T score on F(p) for the VA sample is
Note. Numbers are percentages of participants in each sample an- 62.5 (SD = 18.7), which is considerably lower than the mean T
swering in the keyed direction. Scoring key follows each item in paren- scores for F( 11.3) and Fb (85.6) in this sample. Additionally,
theses (T = true; F = false). Minnesota Multiphasic Personality Inven- only 11.8% of participants in this sample score above a T score
tory—2 (MMPI-2) items and scoring direction of items reprinted from of 90 on F(p) and only 4.4% score above 100. These numbers
MMPI-2: Manual for Administration and Scoring by J. N. Butcher, are considerably lower than the same cutoffs reported in Table
W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989,
Minneapolis, MN: University of Minnesota Press. Copyright 1942, 1 for scales/1 and Fb.
1943, 1951, 1967 (renewed 1970), 1989, and 1995 by the Reagents of Our next set of analyses was designed to test our hypothesis
the University of Minnesota. Reproduced by permission of the Univer- that scores on F(p) would be less highly correlated with general
sity of Minnesota. distress and severe psychopathology than are scores on F and
Fb. Specifically, we assumed that correlations between these
three scales and the MMPI-2 Validity, Clinical, and Content
frequently in the keyed direction by the VA inpatient sample. Scales would reflect a pattern whereby F and Fb have consider-
Again, examination of their content indicates that these items ably higher correlations than F(p) with MMPI-2 measures of
could be expected to have relatively high endorsement frequen- general maladjustment. We also expected that correlations be-
cies in a clinical sample. In the case of Fb, endorsement fre- tween F and Fb and MMPI-2 scales measuring more severe
quencies are, of course, low in the normative sample, which is psychopathology would be higher than the correlations for
the sample that was used to develop this scale. The difference in F(p). However, in this case we expected that the magnitude of
item endorsement frequencies between Fund Fb in the norma- the difference would be smaller because a number of items on
tive sample explains why clinical samples receive higher T F(p) describe psychotic symptoms. Table 5 presents the results
scores on Fb than on F, even if the two scales have comparable of these analyses.3
item endorsement frequencies in a clinical sample. The findings reported in Table 5 are consistent with our ex-
pectations. Correlations between Fund Fb and MMPI-2 scales
measuring general maladjustment (e.g., D, Pt, ANX, and DEP)
Development and Characteristics of the Fp Scale are considerably higher than correlations between F(p) and
these scales. Correlations between F and Fb and MMPI-2 mea-
Our goal in developing the F(p) scale was to identify a set of sures of severe psychopathology (e.g., Pa, Sc, and BIZ) are also
items that is endorsed infrequently by both inpatients and the higher than correlations between F(p) and these scales; how-
normative sample. The first step involved use of the VA sample. ever, the magnitude of the differences is not as great as it is with
We identified all of the MMPI-2 items that were endorsed by the measures of general maladjustment.
20% or fewer of this sample in either the true or false direction.
We then examined these items in the second inpatient sample Incremental Validity of F(p)
collected by Graham and Butcher (1988). We did so separately
To test the incremental validity of F(p), we used data col-
for men and women and, to be retained, an item had to be en-
lected by Graham et al. (1991) in a study of the MMPI-2 va-
dorsed by 20% or fewer of both male and female participants.
Finally, we evaluated the revised list of items in the normative 3
sample and found that none of the items were endorsed in the An analysis of actual item overlap between the three infrequency
keyed direction by more than 20% of the men or women in this scales and MMPI-2 clinical Scales 7 and 8 indicates that our hypotheses
are not affected by item overlap because the levels of overlap for the
sample. This procedure yielded a list of 27 items, 18 keyed true three scales are comparable: F(p) has 25.9% overlap with Scale 8, Fhas
and 9 keyed false, that make up the F(p) scale. A list of these 21%, and Fb has 25%; the respective percentages for the three scales
items is presented in Table 4. Linear T scores for F(p) were with 7 are 0, 1.6, and 5.
428 ARBISI AND BEN-PORATH

Table 4
Infrequency-Psychopathology F(p) Scale Items
Item
No. MMPI-2 item

Keyed True
66 It would be better if almost all laws were thrown away.
114 Sometimes I am so strongly attracted by the personal articles of others, such as shoes, gloves, etc.,
that I want to handle or steal them, though I have no use for them.
162 Someone has been trying to poison me.
193 In walking I am very careful to step over sidewalk cracks.
216 Someone has been trying to rob me.
220 I never worry about my looks.
228 There are persons who are trying to steal my thoughts and ideas.
252 Everything tastes the same.
282 I have been told that I walk during sleep.
291 I have never been in love with anyone.
294 My neck spots with red often.
322 I am afraid of using a knife or anything very sharp or pointed.
323 Sometimes I enjoy hurting persons I love.
336 Someone has control over my mind.
371 1 have often wished I were a member of the opposite sex.
387 I can express my true feelings only when I drink.
478 I hate my whole family.
555 I can't go into a dark room alone even in my own home.

Keyed False
51 I do not read every editorial in the newspaper every day.
77 Once in a while I put off until tomorrow what I ought to do today.
90 I love my father, or (if your father is dead) I loved my father.
93 Sometimes when I am not feeling well I am irritable.
102 I get angry sometimes.
126 I believe in law enforcement.
192 My mother is'a good woman, or (if your mother is dead) my mother was a good woman.
276 I love my mother, or (if your mother is dead) I loved my mother.
501 Talking over problems and worries with someone is often more helpful than taking drugs or
medicine.

Note. Minnesota Multiphasic Personality Inventory—2 (MMPI-2) items and scored direction of items
reprinted from MMPI-2: Manual for Administration and Scoring by J. N. Butcher, W. G. Dahlstrom, J. R.
Graham, A. Tellegen, & B. Kaemmer, 1989, Minneapolis, MN: University of Minnesota Press. Copyright
1942, 1943, 1951, 1967 (renewed 1970), 1989, and 1995 by the Regents of the University of Minnesota.
Reproduced by permission of the University of Minnesota. F(p) scale copyright 1995 by the Regents of the
University of Minnesota.

lidity scales. These data included the MMPI-2 scores of 50 col-
lege students who completed the MMPI-2 twice, once under
standard instructions and a second time under instructions to
fake the presence of psychopathology. We compared these par-
ticipants' scores on Fand F(p) to those of Graham and Butch-
er's (1988) inpatient psychiatric sample.4 First, we conducted
analyses designed to compare the two samples' scores on F and
F(p). These are reported in Table 6.
The results in Table 6 are reported as correlations between
group membership and scale scores to allow a more direct esti-
mate and comparison of the relative effect sizes. The MMPI-2
scales were analyzed using Tscores. First, scores on Fand F(p)
were compared for the college students taking the MMPI-2 un-
der standard instructions and the psychiatric patients. Group
membership (student versus patient) was dummy coded with
students coded 1 and patients coded 2. Thus, a positive correla-
tion between group membership and a scale means that the pa-
tients scored higher on that scale. Table 6 also reports corre-
lations between F and F(p), and a test of the significance of the
difference of the correlations between group membership and
these two scales (i.e., a test of the significance of the differences
between the correlations in the first and second columns for
each gender).
Under standard instructions, we would expect patients to
score considerably higher than nonpatients on F, and we would
expect less of a difference on F(p). This is based on the assump-
tion that F(p) is indeed less sensitive than F to the presence of
psychopathology. Thus, we would predict that the correlation
4
Fb was not included in these analyses because it is not used to de-
termine the validity of an entire MMPI-2 protocol as is F. The college
sample consisted of 30 men and 20 women. The inpatient psychiatric
sample consisted of 211 men and 178 women. For these analyses, a
number of participants (n = 34) who had either excessive numbers of
item omissions or VRIN scores greater than 80 were deleted from Gra-
ham and Butcher's (1988) original inpatient sample.
 THE F(p) SCALE 429

Table 5 ship to be higher than the one found for F. Examination of Table
Correlations Between F, Fb, and Ffpj and Other MMPI-2 6 indicates that the correlations are consistent with this expec-
Scales in the VA Sample tation. F(p) has a greater effect size in discriminating between
the two groups than does the F scale. Again, a / test indicates
Scale F Fb F(P) that these difference are statistically significant (p < .01).
L -.24 -.29 .04 A final set of analyses was designed to provide a direct test of
K -.58 -.65 -.33 the incremental validity ofF(p) in comparison to Fin discrim-
VRIN .01 .00 .09 inating between psychiatric patients and individuals who are
TRIN .19 .17 .29 dissimulating a psychiatric disorder. Here, regression analyses
\(Hs) .38 .38 .18
were performed with group membership, the dependent vari-
2(D) .45 .54 .14
3(Hy) .22 .26 .03 able, regressed on F and F(p) T scores, which served as inde-
4(Pd) .55 .53 .27 pendent variables. Two hierarchical regression analyses were
S(Mj) .13 .16 .00 performed. In the first analysis, F was entered into the regres-
6 (Pa) .74 .70 .51 sion equation first, and the ability ofF(p) to add incrementally
l(Pt) .60 .69 .28
»(Sc) .84 .81 .56 to the prediction of group membership was tested by calculating
9 (Ma) .49 .41 .41 an F(change) statistic. Next, F(p) was entered into the regres-
0(Si) .61 .68 .33 sion equation first and the ability of F to add incrementally to
ANX .65 .76 .29 the prediction of group membership was tested with an
FRS .38 .45 .35
OBS .63 .74 .38 F(change) statistic. These analyses were conducted with both
DEP .70 .83 .34 genders combined to provide greater power for the regression
HEA .58 .57 .31 analyses. Results of these analyses are reported in Table 7.
BIZ .77 .67 .64 Examination of Table 7 indicates that F(p) added signifi-
ANG .56 .61 .27
CYN .59 .57 .44
cantly to F in the prediction of group membership. However,
ASP .56 .51 .40 when the order of entering variables into the regression equa-
TPA .53 .56 .39 tion was reversed, F did not add to F(p) in the discrimination
LSE .69 .80 .41 between psychiatric patients and individuals faking bad. This is
SOD .55 .59 .29 illustrated further by examination of the beta weights generated
FAM .64 .66 .46
WRK .73 .82 .39 by these regression procedures that appear in the last column
TRT .74 .83 .47 of Table 7. Clearly, in the resulting regression formula (which
is, of course identical after both variables are entered), F(p)
Note. N = 706. Correlations greater then |.13| are statistically sig- provides most of the predictive power.
nificant with alpha set at .001 to correct for multiple comparisons. F =
Infrequency; Fb = Infrequency-Back; F(p) = Infrequency-Psychopa- A final analysis was conducted at the suggestion of one of the
thology; MMPI-2 = Minnesota Multiphasic Personality Inventory—2; reviewers of this article who was concerned that highly psy-
L = Lie; K = Correction; VRIN = Variable Response Inconsistency; chotic individuals might score higher than others on F(p). We
TRIN = True Response Inconsistency; Hs = Hypochondriasis; D = compared the F(p) scores of participants in the second psychi-
Depression; Hy = Hysteria; Pd = Psychopathic Deviate; Mf= Mascu- atric sample with a primary diagnosis of schizophrenia (n = 61,
linity-Femininity; Pa = Paranoia; Pt = Psychasthenia; Sc = Schizo-
phrenia; Ma = Hypomania; Si = Social Introversion; ANX = Anxiety; M = 65.74, SD = 21.51) with those of the rest of this sample
FRS = Fears; OBS = Obsessiveness; DEP = Depression; HEA = Health (n = 328, M = 64.93, SD = 20.75) and found no significant
Concerns; BIZ = Bizarre Mentation; ANG = Anger; CYN = Cynicism; difference, t( 387) = 0.28.
ASP = Antisocial Practices; TPA = Type A Behavior; LSE = Low Self-
Esteem; SOD = Social Discomfort; FAM = Family Problems; WRK =
Work Interference; TRT = Negative Treatment Indicators. Discussion
We presented data in this article that illustrate the limitations
of F and Fb as infrequent-response indicators in populations
between group membership (as coded in this analysis) and F that have high base rates of psychopathology. These limitations
would be higher (reflecting a greater difference between the reflect the fact that responses that are infrequent in nonclinical
groups) than the correlation between group membership and samples, such as those used to develop F and Fb, may be less
F(p). The results reported in Table 6 are consistent with these infrequent (or not at all infrequent) in clinical populations. Ex-
predictions, for both men and women. The difference between amination of specific items presented in Tables 2 and 3 supports
these correlations was tested using a / test for the significance of this explanation of elevated scores on scales Fand Fb in clinical
the difference between two correlated correlations, and it was populations. Parenthetically, we observed that some F items are
found to be statistically significant (p < .01). no longer infrequently endorsed by nonclinical samples and
Our next analyses compared the scores of students faking bad that this explains why T score elevations are higher on Fb than
with those of psychiatric patients. Here, membership was coded on Fin samples with high base rates of psychopathology.
1 in the patient group and 2 in the faking group. Thus, a positive To summarize our findings, the newly developed F(p) scale
correlation indicates a higher score in the faking group than in demonstrated good construct validity by performing in line
the patient group. If F(p) does a better job at discriminating with all of our rationally derived predictions. These predictions
between individuals faking bad and psychiatric patients, we were based on an analysis of the reasons why F and Fb are con-
would expect the correlation between F(p) and group member- founded with psychopathology and on the formulation of a po-
430 ARBISI AND BEN-PORATH

Table 6
Correlations Between F and F(p) and Group Membership
Men Women
b
Comparison F(P) r(238) F(p) ?(195)b

Standard college and patient .24 .07 .72 3.65 .26 .15 .81 2.60
Patient and faking instructions .52 .66 .72 3.86 .45 .60 .78 4.15

Note. Standard college is dummy coded 1 and patient is dummy coded 2 for first analysis; patient is
dummy coded 1 and faking instructions are dummy coded 2 in second set of analyses. In the standard
college and faking groups, there were 30 men and 20 women; in the patient group, there were 211 men and
178 women.
1
Correlation between Infrequency, F, and Infrequency-Psychopathology, F(p). b ; test for the significance
of the difference between two correlated correlations, F and group membership versus F(p) and group
membership. With alpha set at .01 to control for multiple comparisons, all four t tests are statistically
significant.

tential remedy for the situation. Additionally, the scale demon-
strated incremental validity relative to existing MMPI-2 scales,
a requirement for any newly proposed MMPI-2 measure. Al-
though the initial development of F(p) was based on a sample
of men, later stages of the scale's development and demonstra-
tion of its relative strength in comparison with F were con-
ducted on a sample that included women. Thus, the scale
should be equally effective for both genders.
On the basis of these findings we suggest that clinicians can
begin using F(p) as an adjunct to the interpretation of F and
Fb. As described in the introduction to this article, three factors
contribute to elevations on F: random responding, faking, and
psychopathology. When encountering an elevated score on F in
an individual who may be expected to have significant psycho-
pathology, the first step in attempting to determine the reason
for the elevation is to examine the VRIN score. If VRIN is ele-
vated beyond a T score of 80, this is a good indication that the
reason for the elevated F score is random responding and that
the protocol is uninterpretable.
If VRIN is not elevated, the next step should be to examine
TRIN. If it is greater than 100, this indicates that acquiescence
or nay-saying likely are responsible for the elevated score on F,
and the protocol should not be interpreted. If both VRIN and
TRIN are not elevated, then the next step should be to examine
F(p). If this scale is elevated, this is a good indication that the
elevation on Fis due to faking (which could be either malinger-
ing of nonexisting problems or exaggeration of existing
difficulties), and the profile should be interpreted accordingly.
IfF(p) is not elevated, this is an indication that the elevation on
Fis likely a reflection of psychopathology.
Missing from our discussion at this point are specific recom-
mendations as to what constitute elevated and nonelevated
scores on F(p). The customary way to ascertain such cutoffs
would be to produce F(p) frequency tables for the faking and
clinical samples. However, using frequency tables in this man-
ner is predicated on the assumption that all of the participant
in the faking group faked bad, and none of the subjects in the
clinical sample faked or exaggerated their responses. We have
no a priori reason to accept either of these assumptions, and
an examination of the data indicated that there were, in fact,
participants in both groups who violated these assumptions.
Given the relatively small size of the faking sample, the resulting
proportions of "accurate predictions" would be particularly
susceptible to distortion by a small number of participants who
did not follow instructions. In addition, our "faking" partici-
pants were college students. A clinical sample instructed to fake
bad would be far more useful for the identification of cutoff
scores.
Further research is needed to identify and study optimal cut-
off points for elevation on F(p). However, the data presented in
this study indicate clearly that the higher the F(p) score, the
more likely it is that an individual has faked bad on the MMPI-
2 and that this score is less likely to be confounded with psycho-
pathology. Although individuals experiencing severe psychopa-
thology may score slightly higher than others on F(p), analyses
presented in this article suggest that this will not have a major
impact on this scale and that F(p) is far less susceptible to these
effects than are F and Fb. T scores over 100 on F(p) (5, SD
above the normative mean) are very likely indicators of faking
and are far less frequently found in clinical populations than
are elevations above 100 on Fand Fb. Such elevations are not,
however, an indication that a person is entirely free of psycho-
pathology. Where one places a cutoff may also depend on the
extent to which false positives and negatives are acceptable. In
any case, blind use of cutoffs scores for any MMPI-2 scale is
Table 7
Regression Analyses: Discriminating Between the Faking-Bad
Group and Psychiatric Inpatients
Final
Variable R * change /^change beta
Entering F First
F .48 .05
F(p) .63 119.9 <.0001 .67
Entering F(p) First
F(p) .63 .67
F .63 0.6 .44 .05
Note. Fctaav. = statistic for incremental increase in multiple correla-
tion; Pdunge = statistical significance of increment in multiple correla-
tion.
 THE F(p) SCALE 431

not recommended because this reduces the validity of the scale
by converting a continuous measure into a dichotomous one.
Further research is also needed to identify the range of appli-
cability of the F(p) scale. The present study focused on inpa-
tients; however, it is likely that F(p) will have usefulness as an
infrequent response indicator in other populations that have high
base rates of psychopathology or psychological distress. These in-
clude outpatient mental health, substance abuse, and certain fo-
rensic settings. Additional research could also focus on the F(p)
scale's sensitivity to more specific types of faking. Existing data
sets could be cultivated further to explore this issue. We expect
that further research will demonstrate the utility of F(p) as a
general MMPI-2 measure of infrequent responding.
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Appendix

Infrequency-Psychopathology Scale, F(p), of the Minnesota Multiphasic Personality

Inventory—2

F(p) Scoring Key

True: 66, 114, 162, 193,216, 228,252,270, 282,291,294, 322, 323, 336, 371, 387,478, 555
False: 51,77,90,93, 102, 126, 192,276,501

T Score Conversion Table

Raw Men Women Raw Men Women Raw Men Women
0 41 41 10 113 120 19 120 120
1 48 49 11 120 120 20 120 120
2 56 57 13 120 120 21 120 120
3 63 65 14 120 120 23 120 120
4 70 73 15 120 120 24 120 120
5 77 81 16 120 120 25 120 120
6 84 89 17 120 120 26 120 120
7 94 97 18 120 120 27 120 120
8 99 105
9 106 113

F(p) scoring key and 7* scores copyright 1995 by the Regents of the University of Minnesota.

Received August 25, 1994

Revision received January 9,1995
Accepted January 18, 1995 I