I’m a clinical social worker and not a clinical psychologist so I wasn’t trained in how to administer and interpret psychological tests like the Rorschach, the well known ink blot test, and the MMPI which requires no skill to administer because it consists of either 567 or, in a newer version, 338 true/false questions. It does require skill to interpret.
I am familiar with MMPI because I when I worked as a therapist in a community mental health center we used it with a minority of clients where we thought weened more information to augment our diagnostic assessment and come up with a treatment plan. We had a clinical psychologist on our staff who helped the rest of us understand what the results meant.
After Trump’s latest performance in a press conference where he seemed to concoct out of thin air a paranoid seeming conspiracy he called Obamagate and refused to say what it was, and the grand finale which culminated with his turning on his heels and walking out in a huff after being asked about testing it occurred to me that there is one test needed for him to make sure he’s free of a dangerous disease for someone with the power of a president.
The MMPI was originally developed in the late 1930’s and early 1940’s as more scales were researched and added. The MMPI was designed to measure the diagnoses of the era. Today it is a quick tool used in employment screening and forensic assessments and in when used in clinical settings would be just a part of an assessment process used to formulate a treatment plan. In my experience I found that most psychotherapists don’t rely on the face-to-face interview at the start of treatment for assessment and don’t use psychological tests.
These are the scales.
Scale 1 Hypochondriasis Measures a person's perception and preoccupation with their health and health issues.
Scale 2 Depression
Scale 3 Hysteria Measures the emotionality of a person.
Scale 4 Psychopathic Deviate
Scale 5 Femininity/Masculinity Scale Measures a stereotype of a person.
Scale 6 Paranoia Scale
Scale 7 Psychasthenia Scale (Measures a person's anxiety levels and tendencies).
Scale 8 (Also known as the Schizophrenia Scale)
Scale 9 Mania
Scale 0 Social Introversion Scale)
Wikipedia
There’s a lot more to interpreting the MMPI than just looking at the individual scales. Again I am not an expert but I know enough to say that someone who is can look at a chart like the one pictured above and see how the pattern of spikes and valleys and describe someone’s personality and presence or absence of psychopathology.
When the test is used to screen candidates of jobs in areas like law enforcement (see Pre-employment Psychological Testing of Police Officers: The MMPI and the IPI as Predictors of Performance) the result can mean the difference between being hired or not being hired.
Perhaps candidates for high political office should be required to take the MMPI. Consider a hypothetical candidate for president, or a current president, and how he or she would rate on these scales from Psych Central’s website.
Psychopathic Deviate (Pd) – The Psychopathic Deviate scale measures general social maladjustment and the absence of strongly pleasant experiences. The items on this scale tap into complaints about family and authority figures in general, self alienation, social alienation and boredom.
Paranoia (Pa) – The Paranoia scale primarily measures interpersonal sensitivity, moral self-righteousness and suspiciousness. Some of the items used to score this scale are clearly psychotic in that they acknowledge the existence of paranoid and delusional thoughts.
Psychasthenia (Pt) -The Psychasthenia scale is intended to measure a person’s inability to resist specific actions or thoughts, regardless of their maladaptive nature. “Psychasthenia” is an old term used to describe what we now call obsessive-compulsive disorder (OCD), or having obsessive-compulsive thoughts and behaviors. This scale also taps into abnormal fears, self-criticisms, difficulties in concentration and guilt feelings.
Schizophrenia (Sc) – The Schizophrenia scale measures bizarre thoughts, peculiar perceptions, social alienation, poor familial relationships, difficulties in concentration and impulse control, lack of deep interests, disturbing question of self-worth and self-identity, and sexual difficulties.
Hypomania (Ma) – The Hypomania scale is intended to measure milder degrees of excitement, characterized by an elated but unstable mood, psychomotor excitement (e.g., shaky hands) and flight of ideas (e.g., an unstoppable string of ideas). The scale taps into overactivity — both behaviorally and cognitively — grandiosity, irritability and egocentricity.
I am certain that clinical psychologists who have administered thousands of MMPI tests and who are alarmed by Trump’s behavior could tell you what they think his profile would look like just by citing the score on the scales, for example a high x,y, and z, and a low a and b. Those who use the MMPI part of employment assessments for jobs in law enforcement and the military could tell you what their recommendation would be, hire or don’t hire.
For example, Steve Buser, MD, a psychiatrist for the United States Air Force who had as one of his responsibilities evaluating the mental stability of airmen who handled nuclear weapons, using the standards laid out in what is called the Nuclear Personnel Reliability Program. I don’t know if he used the MMPI, as a psychiatrist and not a clinical psychologist he may not have had this in his toolbox.
In his NY Times OpEd “Would the Air Force Let Airman Trump Near a Nuclear Weapon?” (Jan. 17, 2018) he wrote:
I have not had the opportunity to examine the president personally, but warning signs abound. What if I had reliable outside information that Airman Trump displayed erratic emotions? That I saw very clearly that he was engaging in cyberbullying on Twitter? That he had repeatedly made untruthful or highly distorted statements? That his language implied he engaged in sexually abusive behavior? That he appeared paranoid about being surveilled or persecuted by others, that he frequently disregarded or violated the rights of others?
These are the sorts of things that set off alarms for Air Force psychiatrists. I certainly could not certify him as “P.R.P. ready” without more extensive psychological evaluation.
It does not take a former Air Force psychiatrist to point out that our country finds itself in a place unlike any we’ve ever been before. Saturday morning’s alarm in Hawaii, as residents read alerts that incoming ballistic missiles were on their way, is a wakeup call to the very real danger we’re facing. Global tension and angst are significantly heightened.
We’ve been here a few times before, but unlike those other times our commander-in-chief adds, without equivocation, to this angst almost daily with his words and actions. We have always assumed that the person at the top has the mental fitness to meet whatever standards the Air Force set for the rest of the chain of command. What keeps me up at night? The realization that, at the worst possible time, we have a chief executive who I believe would probably fail the P.R.P.
In December 2019 at least 700 mental health professionals signed letter to Congress claiming Trump's mental health was deteriorating dangerously amid impeachment proceedings. At that time they wrote:
"What makes Donald Trump so dangerous is the brittleness of his sense of worth. Any slight or criticism is experienced as a humiliation and degradation. To cope with the resultant hollow and empty feeling, he reacts with what is referred to as narcissistic rage.
"He is unable to take responsibility for any error, mistake, or failing. His default in that situation is to blame others and to attack the perceived source of his humiliation. These attacks of narcissistic rage can be brutal and destructive."
In a recent Salon interview forensic psychiatrist Bandy X. Lee said:
Listen to the experts! Mental health expertise is just as important as physical health expertise, if not more so, since a person's mental problems are inversely proportional to the willingness of the person to admit that there is a problem. So it is obvious where we stand as a society. Even those who recognize that the president has a mental problem do not think to say, "Let's call a doctor!" Like the coronavirus, the problem does not go away just because we avoid doing the testing.
What is important is prevention, as we have not seen the worst. Our "prescription for survival" lists all possible interventions. People feel needlessly helpless when there is a lot we can do: Citizens are mobilizing, even non-psychiatrist doctors. The 25th Amendment could be approached if overwhelming public opinion compelled it, and we have enormous data on presidential incapacity to educate about. A second impeachment would also be effective, with televised hearings on the president's handling of the coronavirus pandemic. We previously begged the speaker [Nancy Pelosi] to continue holding onto the articles of impeachment, as it was the one means we had of setting limits on the ballooned expectations from delaying impeachment for so long. Imagine what a different place we would be in if she had listened to us!
At a minimum, the House speaker could immediately establish an emergency crisis committee, calling on top CDC and Trump administration officials to answer all questions about the handling of the pandemic and what is being done to correct past errors. She would be demonstrating leadership in deferring to experts. With the information gathered over just a few days, the Congress can then assume its responsibilities in this dire emergency and not simply respond to the whims of a president whose briefings are nothing short of deadly.
Trump was manifesting behavior that led mental health professionals who could legitimately be called eminent (unlike this small town former mental health center director who wrote about it in more than 100 diaries here) to explain why he was not only unfit to be president but outright dangerous.
This was years before Covid-19 could even have been imagined and before Rachel Maddow who among MSNBC hosts has been the most clueless about Trump’s psychopathology said the following:
It doesn’t take an astute mental health professional to see that Trump has become more unstable in the past week than ever before. You don’t need a mental health degree to agree with the experts that Trump’s behavior, from his obsessive rage tweeting for hours on end to his bullying and angry outbursts towards people asking innocent questions are of grave concern. If they were a family member we’d want them admitted to a psychiatric hospital for an assessment.