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Published online by Cambridge University Press: 15 April 2020
This paper explores content, construct, measurement and interpretation issues surrounding the Millon Clinical Multiaxial Inventory III that can lead to misdiagnosis - especially of abuse victims. The analysis is based around an extremely serious ‘Miscarriage of Justice’ case where ‘evidence’ from the Millon resulted in revictimisation of two victims of extreme abuse. The 10 following issues will be discussed:
1. Use of ordinary ‘Big 5’ trait marker items in supposedly clinical scales.
2. Use of misleading scale labels that fail to adequately represent scale item content.
3. Lack of factor-analysis data in manual on the underlying structure of the data.
4. Lack of correlation in manual with Big 5 trait markers such as NEO and its 30 facets.
5. Use of derived scores without sensible cross-reference to primary pathology scales.
6. Multiple scoring of items leading to scale overlap.
7. Over-simplistic use of ‘bench-mark’ values that can be easily affected by responses to just one or two items.
8. Failure to take account of ‘sick’ environments (i.e. assumption that the world/environment is ‘healthy’ when there is always the risk of extreme abusers a la Marc Detroux, Jimmy Saville or Ian Watkins).
9. Overly simplistic expert system reporting that ignores the body of evidence on ‘typical’ profiles and low certainty given lack of differential validation evidence.
10. Lack of a developmental perspective on issues such as PTSD and Dissociation spectrum disorders.
The application of the Lacter & Lehmann (2008) guidelines is recommended whenever disclosures of a client are of an ‘unbelievable’ nature’.
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