Theodore Millon, PhD, DSc, Seth Grossman, PsyD, Carrie Millon, PhD

MCMI®-IV
The most widely-used theory-driven
and empirically guided adult clinical
personality instrument
The MCMI-IV assessment delivers Dr. Millon’s time-tested
theories on personality patterns in an all-new spectrum.
 “
 The MCMI®-IV was specifically designed, “
as are all of the Millon® Inventories,
to facilitate the therapeutic plans of the clinician.
—Theodore Millon, PhD, DSc

Grounded in both theoretically guided principles and sound empirical research,

the MCMI‑IV helps to diagnose personality disorders, identify underlying clinical issues,
and capture a broader range of personality functioning. Used in multiple settings including
clinical and counselling, medical, government, and forensic, the MCMI-IV can help:

» Identify deeper pervasive clinical issues

» Facilitate treatment decisions
» Assess disorders based on DSM-5® and ICD-10 classification systems

A Theoretical Change—Introducing a ‘Spectrum’

Dr. Millon’s Disorders of Personality, Third Edition (Wiley: 2011) more fully explicated
a range of personality dysfunction AND function.

The MCMI-IV conceptualizes personality patterns on a new spectrum.

Each behaviour is now described with 3 levels of personality functioning:

» Normal Style: Generally adaptive personality patterns

» Abnormal Traits/Type: Moderately maladaptive personality attributes
» Clinical Disorder: Likelihood of greater personality dysfunction

Example: CENarc spectrum: Confident–Egotistic–Narcissistic

The major goal of the MCMI-IV is to more adequately capture this broader range
of personality—adaptive to maladaptive.

2
Advantages of Dr. Millon’s Theory
The MCMI-IV is uniquely equipped to provide clinical
insights that are grounded in both theoretically-guided
principles and sound empirical research. Rather than
starting with statistical methodology, the MCMI-IV
Overview
and all the Millon inventories begin with explanatory Administer to:
principles. This allows the clinician to grasp the how Adults aged 18 and older
and why from the data to truly understand the person Administration Time:
behind the numbers. It then blends together theory 25–30 minutes
and statistics to form a cohesive understanding of a
Scoring and Reporting:
person’s personality.
Q-global, Q Local™ and
Mail-in
The MCMI-IV at a Glance Qualification Level:
New Features C
» Full normative update—Based on a combined Reading level:
gender sample of 1,547 adults from inpatient and Fifth grade
outpatient clinical settings
» New Turbulent scale—Uses a modern formulation of
the Turbulent personality pattern to provide deeper
understanding of those patients presenting with
this unbridled personality type
» DSM-5® and ICD-10—Aligns with DSM-5; includes
ICD-10 code sets
» New and updated test items—Characterize the
evolution of Dr. Millon’s personality theory,
increase clarity and clinical relevance
» Enhanced Therapeutic Focus—New and improved
narrative content that better integrates results with
therapeutic practice
» Updated Grossman Facet Scales—Designed
to help interpret elevations on the Clinical
Personality Patterns Scales and Severe Personality
Pathology Scales
» Digital—New digital end-to-end workflow via
Q-global®

3
 Grounded in both t heoretically guided
principles and s ound empirical r esearch.

Turbulent Scale—New!
MCMI®-IV Scale 4B: Ebullient-Exuberant-Turbulent Spectrum
The Turbulent scale on the MCMI-IV will provide clinicians with a deeper understanding of
the levels of severity found in clinical adult patients who may be presenting with abnormal
personality traits, such as a lost sense of reality or unwavering optimism. “Turbulent” refers
to the more severe (disorder) end of that spectrum. The MCMI-IV can help you identify how
adaptive/maladaptive it is, how it differentiates itself by virtue of different personality mixtures,
and gives you a solid place to begin to intervene.

Dr. Millon conceptualized the Ebullient–Exuberant–Turbulent personality pattern as typically

energetic and buoyant in manner and prone to vigorous pursuits of happiness. The high energy
and generally positive attitude of moderated variants of this pattern can show considerable
characterologic strengths. Patients with less integrated variations of this pattern may be prone
to scatteredness, overstimulation, over-animation, and an inability to maintain balance within
>> their environment, which can adversely affect their relationships with others.

Learn more about the Turbulent personality pattern and

new Turbulent scale at PearsonClinical.ca/MCMI-IV.

4
 Updated Grossman Facet Scales
The Grossman Facet Scales enhance the clinical interpretation of the MCMI-IV by further elaborating
on the different personality dimensions, making connections between the primary scales.

Clinical Personality Patterns and the 6A Antisocial (ADAntis)

Corresponding Grossman Facet Scales 6A.1 Interpersonally Irresponsible
6A.2 Autonomous Self-Image
1 Schizoid (AASchd)
6A.3 Acting-Out Dynamics
1.1 Interpersonally Unengaged
6B Sadistic (ADSadis)
1.2 Meager Content
6B.1 Expressively Precipitate
1.3 Temperamentally Apathetic
6B.2 Interpersonally Abrasive
2A Avoidant (SRAvoid)
6B.3 Eruptive Architecture
2A.1 Interpersonally Aversive
7 Compulsive (RCComp)
2A.2 Alienated Self-Image
7.1 Expressively Disciplined
2A.3 Vexatious Content
7.2 Cognitively Constricted
2B Melancholic (DFMelan)
7.3 Reliable Self-Image
2B.1 Cognitively Fatalistic
8A Negativistic (DRNegat)
2B.2 Worthless Self-Image
8A.1 Expressively Embittered
2B.3 Temperamentally Woeful
8A.2 Discontented Self-Image
3 Dependent (DADepn)
8A.3 Temperamentally Irritable
3.1 Expressively Puerile
8B Masochistic (AAMasoc)
3.2 Interpersonally Submissive
8B.1 Undeserving Self-Image
3.3 Inept Self-Image
8B.2 Inverted Architecture
4A Histrionic (SPHistr)
8B.3 Temperamentally Dysphoric
4A.1 Expressively Dramatic
4A.2 Interpersonally Attention- Severe Personality Pathology and
Seeking Corresponding Grossman Facet Scales
4A.3 Temperamentally Fickle
S Schizotypal (ESSchizoph)
4B Turbulent (EETurbu) S.1 Cognitively Circumstantial
S.2 Estranged Self-Image
4B.1 Expressively Impetuous
S.3 Chaotic Content
New! 4B.2 Interpersonally High-Spirited
C Borderline (UBCycloph)
4B.3 Exalted Self-Image
C.1 Uncertain Self-Image
5 Narcissistic (CENarc)
C.2 Split Architecture
5.1 Interpersonally Exploitive
C.3 Temperamentally Labile
5.2 Cognitively Expansive
P Paranoid (MPParaph)
5.3 Admirable Self-Image
P.1 Expressively Defensive
P.2 Cognitively Mistrustful
P.3 Projection Dynamics

5
 Enjoy a digital end-to-end workflow
with the digital manual via Q-global®

Scoring and Reporting

Administration, scoring, and reporting for the MCMI®‑IV is available
on Q-global®, Pearson’s web‑based scoring and reporting platform.
®

Q-global
®

Q-global features:

» 24/7 secure, web-based access

» Portable use on mobile devices, laptops, and tablets
» On-demand, reliable scoring and comprehensive reporting solutions

For information about Q-global, please visit HelloQ.ca.

Mail-in and Q-Local™ scoring and reporting options also available.

Sample Reports
Profile Report
The Profile Report provides base rate scores for all 28 scales in an easy-to-read graph. This
report can help clinicians quickly identify clients who may require more intensive evaluation.
MCMI®-IV Interpretive Report ID: 123456789
10/09/2015, Page 3 Joan Sample

Customizable Reporting MILLON CLINICAL MULTIAXIAL INVENTORY-IV

PROFILE SUMMARY

This section presents the new scale abbreviations, a customizable reporting option available in
HIGH-POINT CODE =
BR ADJUSTMENTS =
8A 6A 2B
X, A/CC
INVALIDITY (V) =
INCONSISTENCY (W) =
0
14

the MCMI‑IV.
Score Profile of BR Scores
VALIDITY
Raw BR 0 35 75 100
Modifying Indices Low Average High
Disclosure X 75 88
Desirability Y 12 60
Debasement Z 24 88

Score Profile of BR Scores

PERSONALITY
Raw PR BR 0 60 75 85 115
Clinical Personality Patterns Style Type Disorder

AASchd 1 11 64 66

E
SRAvoid 2A 10 58 70

L
DFMelan 2B 22 84 78

P
DADepn 3 11 71 73
SPHistr 4A 13 53 62

M
EETurbu 4B 15 59 65
Cust

SA
CENarc 5 10 74 69
om
Repo izable
ADAntis 6A 17 99 92
ADSadis 6B 10 75 68
RCComp
DRNegat
7
8A
10
24
16
99
40
96
rting
AAMasoc 8B 13 72 71
Severe Personality Pathology
ESSchizoph S 12 65 65
UBCycloph C 24 99 97
MPParaph P 10 75 71

Score Profile of BR Scores

PSYCHOPATHOLOGY
Raw PR BR 0 60 75 85 115
Clinical Syndromes Present Prominent
GENanx A 7 57 78

6
SOMsym H 8 59 66
BIPspe N 5 38 58
PERdep D 26 97 107
ALCuse B 6 92 83
DRGuse T 5 74 67
P-Tstr R 4 48 60
Severe Clinical Syndromes
SCHspe SS 12 68 64
MAJdep CC 16 79 86
DELdis PP 4 74 64
Interpretive Report
This report provides an in-depth analysis of personality and symptom dynamics.
Written with a therapeutic focus, the interpretive report provides the clinician with a
foundation upon which treatment plans can readily be made and includes action-oriented
suggestions for therapeutic management.

Interpretive Report Features

Aligns to DSM-5® and Includes
ICD-10 Code Sets Therapeutic Focus
This section provides possible DSM-5 This section provides major considerations
diagnoses that parallel with diagnostic and recommendations for treatment options
criteria and items from the MCMI-IV. based on individual results.

MCMI®-IV Interpretive Report ID: 123456789 MCMI®-IV Interpretive Report ID: 123456789
10/09/2015, Page 9 Joan Sample 10/09/2015, Page 10 Joan Sample

Self-Destructive Potential Special Note: Course: The clinical syndromes described previously tend to be relatively transient, waxing and waning in their
14. I Item
began to feel Omitted
Content like a failure some years ago. (True)
(True) The content of the test items prominence and intensity depending on the presence of environmental stress.
ITEMS
32. I Item
just haven't
Contenthad the luck
Omitted in life that others have had. (True) NOT
(True) is included in the actual reports.
34. I've
Itembecome
Content quite discouraged
Omitted SHOWN To protect the integrity of the
(True) and sad about life in the past year or two. (True) Personality Disorders
Deeply ingrained and pervasive patterns of maladaptive functioning underlie clinical syndromal pictures. The
39. I Item
oftenContent
think that deserve the good things that happen to me. (True)measure, the item content does
I don't (True)
Omitted
not appear in this sample report. following personality prototypes correspond to the most probable DSM-5 diagnoses that characterize this patient.
101. I Item
feel deeply
Contentdepressed for no reason I can figure out. (True)
Omitted (True)
114. InItem
recent weeks,
Content my mood
Omitted has become increasingly sad. (True)
(True) Personality configuration composed of the following:
151. For
Itemsome timeOmitted
Content now, I've(True)
been feeling very guilty because I can't do things right anymore. (True)
164. I Item
oftenContent
get so upset that(True)
Omitted I want to hurt myself seriously. (True) 301.83 (F60.3) Borderline Personality Disorder
301.9 (F60.9) Unspecified Personality Disorder (Negativistic) Disorder
Childhood Abuse with Antisocial Personality Type
and Unspecified Personality Disorder (Melancholic) Style
47. I'm ashamed
Item ContentofOmitted
some of(True)
the abuses I suffered when I was young. (True)
Course: The major personality features described previously reflect long-term or chronic traits that are likely to
Vengefully Prone have persisted for several years prior to the present assessment.
22. I Item
feel terribly
Contentdepressed and sad much of the time now. (True)
Omitted (True)

E E
37. MyItemmoods seem
Content to change
Omitted a great deal from one day to the next. (True)
(True) Psychosocial and Environmental Problems

L L
111. I Item
feel lonely
Contentand empty (True)
Omitted most of the time. (True) In completing the MCMI-IV, this individual identified the following problems that may be complicating or
167. I Item
oftenContent
find thatOmitted
I've been treated unfairly. (True)
(True) exacerbating her present emotional state. They are listed in order of importance as indicated by the patient. This

P P
178. I Item
oftenContent
feel veryOmitted
unhappy with who I am. (True) information should be viewed as a guide for further investigation by the clinician.
(True)
192. I Item
sometimes
Contentfeel I deserve
Omitted to be unhappy. (True)
(True)

M M
Low Self-Confidence

Explosively Angry

SA SA
11. As a teenager,
Item I got into(True)
Content Omitted lots of trouble because of bad school behavior. (True) Align TREATMENT GUIDE
74. I Item
haveContent
difficultyOmitted
controlling my anger. (True)
the D s to
(True)
168. I Item
quickly show Omitted
Content my anger(True)
at people who disagree with me. (True)
S Ther
inclu M-5; ape
The following guide to treatment planning is oriented toward issues and techniques of a short-term character,
191. Too
Itemmany rulesOmitted
Content get in the way of doing what I want. (True)
(True)

Focu utic
focusing on matters that might call for immediate attention, followed by time-limited procedures designed to
d
ICD- es
reduce the likelihood of repeated relapses.
Autism Spectrum
s
code 10
179. I Item
don'tContent
like to change my
Omitted routine. (True)
(True) As a first step, it would appear advisable to implement methods to ameliorate this patient's current state of clinical
190. I Item
reallyContent
don't understand human feelings like other people do. (True)
Omitted (True) anxiety, depressive hopelessness, or pathological personality functioning by the rapid implementation of
sets supportive psychotherapeutic measures. With appropriate consultation, targeted psychopharmacologic
medications may also be useful at this initial stage.
POSSIBLE DSM-5® DIAGNOSES Worthy of note is the possibility of a troublesome alcohol and/or substance-abuse disorder. If verified, appropriate
short-term behavioral management or group therapy programs should be rapidly implemented.
The following diagnostic assignments should be considered judgments of personality and clinical prototypes that
correspond conceptually to formal diagnostic categories. The diagnostic criteria and items used in the MCMI-IV Once this patient's more pressing or acute difficulties are adequately stabilized, attention should be directed
differ somewhat from those in the DSM-5, but there are sufficient parallels in the MCMI-IV items to recommend toward goals that would aid in preventing a recurrence of problems, focusing on circumscribed issues and
consideration of the following assignments. It should be noted that several DSM-5 clinical syndromes are not employing delimited methods such as those discussed in the following paragraphs.
assessed in the MCMI-IV. Definitive diagnoses must draw on biographical, observational, and interview data in
addition to self-report inventories such as the MCMI-IV. A clear understanding and appreciation of the self-protective nature of this woman's hostilities are necessary to
create a therapeutic alliance. She likely has limited experience relating to others on a genuinely empathic level,
Before each disorder name, ICD-9-CM codes are provided, followed by ICD-10-CM codes in parentheses. while having that attitude reciprocated. Her experience of antagonism throughout her lifetime has gone from being
absorbed inwardly to being projected outwardly with little deviation between these two extremes. Her initial
Clinical Syndromes discomfort with the more equitable dynamic inherent in therapeutic relationships may feel like a failure to connect
The major complaints and behaviors of the patient parallel the following clinical syndrome diagnoses, listed in to the therapist, but it is a necessary intermediate step on the road to a deeper trust. Equally imperative, is to
order of their clinical significance and salience. guide this woman to become aware of her unusual emotional state in the immediate. Hostilities are likely to
emerge and dissipate, possibly repeatedly, and she may attempt to arouse the therapist's ire through testing or
296.33 (F33.2) Major Depression (recurrent, severe) caustic behaviors. A firm but open therapeutic stance, one that withholds judgment, is necessary to gradually
305.00 (F10.10) Alcohol Use Disorder build trust. Further, this approach to therapy will bring with it a receptivity to challenge and an understanding that
309.24 (F43.22) Adjustment Disorder with Anxiety this woman can meet his personal needs with means other than aggression.

MCMI®-IV Interpretive Report ID: 123456789

10/09/2015, Page 10 Joan Sample

Course: The clinical syndromes described previously tend to be relatively transient, waxing and waning in their
prominence and intensity depending on the presence of environmental stress.

Personality Disorders
Deeply ingrained and pervasive patterns of maladaptive functioning underlie clinical syndromal pictures. The
following personality prototypes correspond to the most probable DSM-5 diagnoses that characterize this patient.

Personality configuration composed of the following:

Align
301.83 (F60.3) Borderline Personality Disorder the D s to
S
inclu M-5;
301.9 (F60.9) Unspecified Personality Disorder (Negativistic) Disorder
with Antisocial Personality Type
and Unspecified Personality Disorder (Melancholic) Style
des
Course: The major personality features described previously reflect long-term or chronic traits Ithat
CD are- likely to
have persisted for several years prior to the present assessment. code 10
sets

E
Psychosocial and Environmental Problems

L
In completing the MCMI-IV, this individual identified the following problems that may be complicating or
exacerbating her present emotional state. They are listed in order of importance as indicated by the patient. This

P
information should be viewed as a guide for further investigation by the clinician.

M
Low Self-Confidence

SA
TREATMENT GUIDE
The following guide to treatment planning is oriented toward issues and techniques of a short-term character,
focusing on matters that might call for immediate attention, followed by time-limited procedures designed to
reduce the likelihood of repeated relapses.

As a first step, it would appear advisable to implement methods to ameliorate this patient's current state of clinical
anxiety, depressive hopelessness, or pathological personality functioning by the rapid implementation of
supportive psychotherapeutic measures. With appropriate consultation, targeted psychopharmacologic
medications may also be useful at this initial stage.

Worthy of note is the possibility of a troublesome alcohol and/or substance-abuse disorder. If verified, appropriate
short-term behavioral management or group therapy programs should be rapidly implemented.

Once this patient's more pressing or acute difficulties are adequately stabilized, attention should be directed
toward goals that would aid in preventing a recurrence of problems, focusing on circumscribed issues and
7
employing delimited methods such as those discussed in the following paragraphs.

A clear understanding and appreciation of the self-protective nature of this woman's hostilities are necessary to
create a therapeutic alliance. She likely has limited experience relating to others on a genuinely empathic level,
while having that attitude reciprocated. Her experience of antagonism throughout her lifetime has gone from being
absorbed inwardly to being projected outwardly with little deviation between these two extremes. Her initial
discomfort with the more equitable dynamic inherent in therapeutic relationships may feel like a failure to connect
to the therapist, but it is a necessary intermediate step on the road to a deeper trust. Equally imperative, is to
guide this woman to become aware of her unusual emotional state in the immediate. Hostilities are likely to
emerge and dissipate, possibly repeatedly, and she may attempt to arouse the therapist's ire through testing or
>> About the Authors

Theodore Millon, PhD, DSc Seth Grossman, PsyD

After completing his dissertation in Seth Grossman, PsyD, is a licensed
1953, Dr. Millon began his teaching psychologist in the state of Florida.
career at Lehigh University in He is the founder and clinical
Pennsylvania. It was during his director of the Center for
first year in this position that he Psychological Fitness in the Fort Lauderdale region,
began his own evolution from merely teaching
as well as a member of the clinical faculty at the Florida
psychology to patient advocacy, revolutionizing the
International University Herbert Wertheim College of
assessment treatment continuum, and development of
Medicine. For nearly two decades, Dr. Grossman worked
the personality test that would eventually become today’s
under the leadership of the world-renowned personality
MCMI‑IV.
theorist, Dr. Theodore Millon, co-authoring several
While touring the Allentown State Hospital with his books, scientific articles, and personality tests with
students, he was appalled with the conditions the Dr. Millon. Dr. Grossman has also been a guest lecturer
patients were forced to endure. Following his exposure on personality and clinical assessment at universities
of the conditions of the hospital, Dr. Millon was voted and professional settings nationally and internationally.
president of the Board of Trustees. Over the next Most recently, Dr. Grossman co-authored the MCMI-IV,
decade, the hospital’s standings improved from the latest revision to Dr. Millon’s widely used measure of
22nd out of 22 hospitals in the state to 1st, vastly due adult psychopathology.
to the development of clinical research programs, and
community mental health centers.

Dr. Millon immersed himself into the lives of the

“
patients, and was rewarded for his efforts with a A lasting imprint of Ted will be the
much deeper understanding of those housed in the
chronic wards. He has credited his time there during millions of Americans who will be “
“unconventional visiting hours” as his inspiration for better understood because of his
writing Modern Psychopathology (MP) and developing
diagnostic tools such as the MCMI. He went on to write,
clinical instruments.
co-author, and edit more than 30 books; held full –Hertz Presentation at the
professor roles at Harvard, University of Illinois in 2015 Annual Society for
Chicago, and the University of Miami; and developed a Personality Assessment Convention
number of personality and psychological assessments
still widely in use today.

During the development of the MCMI-IV, Dr. Millon shared

his ideas on the importance of “understanding theory Contact us
and assessment and how they coordinate together
1-866-335-8418
to give us the central core of the emergence of the field
[email protected]
of personality disorders.”

>> Visit PearsonClinical.ca/MCMI-IV to

view the video

1-866-335-8418 | PearsonClinical.ca
Copyright © 2016 Pearson Education, Inc. or its affiliate(s). All rights reserved. Q-global, Q Local, Always Learning, Pearson, Psi design, and PsychCorp
12/16

are trademarks, in the U.S. and/or other countries, of Pearson Education, Inc. or its affiliate(s). DSM-5 is a registered trademark of American Psychiatric
Association. MCMI and Millon are registered trademarks of DICANDRIEN, Inc.