The Millon Adolescent Clinical Inventory (MACI®) (1993 & 2006)
By Theodore Millon, Ph.D., with Carrie Millon, Ph.D., Roger Davis, Ph.D., & Seth Grossman, Psy.D.
As with the MCMI-III, this instrument has seen the development of a series of facet subscales (the MACI Grossman Facet Scales) to further refine the clinical domains that call for the clinician's special attention.
The MACI inventory (Millon Adolescent Clinical Inventory), like other Millon inventories, is distinguished from other clinical instruments primarily by its brevity, its theoretical anchoring, multiaxial format, tripartite construction and validation schema, use of base rate scores, and interpretive depth. The MACI inventory supplements the Millon Adolescent Personality Inventory (MAPI)in that it was developed specifically for use in clinical, residential, and correctional settings. It is useful primarily in the evaluation of troubled adolescents, and may be used for diagnostic assistance, in formulating treatment plans, and as an outcome measure.
At 160 items, the MACI inventory is much shorter than comparable instruments. The MACI test is almost self-administering. Terminology is geared to an sixth-grade reading level. The great majority of youngsters can complete the inventory in approximately 20 minutes, minimizing resistance among the population for which the test is intended. The MACI test is linked directly to a coherent theory of personality and psychopathology, significantly increasing the inventory's interpretive value. Personality scales reflect adolescent variants of the adult personality disorders, refined through Millon's Evolutionary model. No other diagnostic instrument currently available is as consonant with the official nosology as the MACI test. Moreover, the MACI inventory's scales are grouped to reflect the DSM distinction between Axis II and Axis I. Thus, separate scales distinguish the more enduring personality characteristics of patients (Axis II) from the more acute clinical disorders they display (Axis I). Profiles based on all scales may be interpreted to illuminate the interplay between long-standing characterological patterns and the distinctive clinical symptoms currently manifest. As noted, the addition of what are termed the Grossman Facet Scales assist the clinician in further refining the utility of the MACI by identifying the youngster's most salient domains that are problematic, thereby providing an optimal guide for therapy and counseling.
The MACI test consists of a total of 31 scales: Twelve Personality Patterns scales (Axis II), eight Expressed Concerns Scales, seven Clinical Syndrome Scales, three Modifying Indices (which assess particular response styles), and a Validity scale. The table below lists the inventory's scales. The twelve personality patterns parallel those of the DSM-III, III-R, and IV. The Expressed Concerns scales focus on feelings and attitudes about issues that tend to concern most troubled adolescents. The Clinical Syndromes scales assess disorders frequently seen in adolescent populations. As noted, in 2006, a series of Facet Subscales oriented to the personologic/clinical domains have been added to the basic personality scales.
MACI Personality Scale (DSM Equivalent)
- 1 Introversive (Schizoid)
- 2A Inhibited (Avoidant)
- 2B Doleful (Depressive)
- 3 Submissive (Dependent)
- 4 Dramatizing (Histrionic)
- 5 Egotistic (Narcissistic)
- 6A Unruly (Antisocial)
- 6B Forceful (Sadistic)
- 7 Conforming (Compulsive)
- 8A Oppositional (Negativistic or Passive-Aggressive)
- 8B Self-Demeaning (Masochistic or Self-Defeating)
- 9 Borderline Tendency (Borderline)
- Identity Confusion
- Body Disapproval
- Sexual Discomfort
- Peer Insecurity
- Social Insensitivity
- Family Discord
- Childhood Abuse
- Eating Dysfunctions
- Substance-Abuse Proneness
- Delinquent Predisposition
- Impulsive Propensity
- Anxious Feelings
- Depressive Affect
- Suicidal Tendency
Computer Scoring and Interpretation
Computer programs are available for rapid and convenient machine scoring in all major computing environments. (sample narrative report)
Interpretive reports are available at two levels of detail. The PROFILE REPORT presents the adolescent's scores and profile, and is useful as a screening device to identify patients that may require more intensive evaluation or professional attention.The NARRATIVE REPORT integrates both personological and symptomatic features of the patient, and are arranged in a style similar to those prepared by clinical psychologists. Results are based on actuarial research, Millon's theoretical schema, and relevant DSM diagnoses within a multiaxial framework. Therapeutic implications are included.