Review by Yossef S. Ben-Porath, Ph.D.		Review of the Multiaxial Diagnostic Inventory (Revised Edition) The Multiaxial Diagnostic Inventory – Revised Edition (MDI-R) was developed to serve as a “criterion-referenced diagnostic screening instrument designed to assess personality disorders and clinical syndromes.” (Doverspike, 1999, p.1). It consists of four sets of scales: Personality Scales, Adult Clinical Scales, Adolescent Clinical Scales, and Child Clinical Scales. Each set of scales consists of several subscales made up of lists of items that are based on criteria for specific DSM-IV (American Psychiatric Association, 1994) diagnoses. The MDI-R has a professional manual that describes the test, identifies user qualifications, provides the test developer’s theoretical perspective, describes a variety of proposed clinical applications and provides procedures for test administration scoring, and interpretation. The professional manual also includes 19 case examples. Appendix material provides the composition of the four sets of scales and comparisons with the original version of the MDI. The MDI-R professional manual is well organized and provides helpful information regarding test administration, scoring, and interpretation. The author offers cogent warnings about the need to integrate information from the MDI-R with other sources of clinical information before reaching any specific diagnostic conclusions. He also cautions that because the test lacks validity scales it is susceptible to self-report response sets. The test author indicates that the instrument may be used as a self-report inventory, a clinician rating scale, or both. Examination of the MDI-R scales indicates that the test items are written clearly and appear to conform closely to the DSM-IV criteria they were designed to represent. A clinician seeking to screen for the presence of the DSM-IV criteria tapped by these scales will find the MDI-R manual and materials quite user-friendly and accommodating. Rather than commit the DSM-IV criteria to memory, the clinician can use the MDI-R material as a checklist for assessing whether an individual satisfies criteria for a variety of DSM-IV diagnoses. The child version may be administered, when appropriate, to a parent, rather than the child. Ease of administration, the ability to rely on more than one source in completing the MDI-R, and the ability to quantify the number of criteria a client meets in each diagnostic category are the primary positive features of the instrument. However, an essential feature of professional manuals for psychological tests is rather glaringly absent from the MDI-R manual. No psychometric data on the test’s reliability or validity are provided. Although the author notes that the MDI-R is “criterion-referenced” rather than normatively based, one might nonetheless expect to find data on test-retest and inter-rater reliability of the instrument’s scales. Given the focus on DSM-IV diagnosis, one might also expect to find data on MDI-R validity in reference to structured diagnostic interviews. Demonstration that the MDI-R diagnostic suggestions are reasonably reliable and valid would seem essential before the test could be put to routine clinical use. Also noteworthy is the absence of any published empirical research on the MDI-R. An area where empirical research might be particularly helpful, is in examining the utility of an index designed to quantify the validity of self-report-based MDI-R scores. The test author proposes a way to evaluate the validity of an individual’s responses to the MDI-R by having a clinician complete the instrument as well, and comparing quantitatively the scores generated by these two methods of administration yielding a “Validity Index.” The index is calculated by subtracting the total number of clinician “Yes” responses from the total number of client “Yes” responses. The higher the index score, the greater the likelihood of exaggeration or extreme distress. The lower a negative score, the greater the likelihood of client denial or minimization. Empirical research is needed to determine whether, overall, the Validity Index functions as the author proposes and to identify specific cutoffs for flagging invalid responding. Overall, the MDI-R is a promising instrument that may be useful as a checklist for quantifying the extent to which individuals meet DSM-IV-based diagnostic criteria. Research examining the test’s reliability, validity and the proposed validity index is needed to assist the practitioner in determining the extent to which the test fulfills its promise. References American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Press. Doverspike, W.F. (1999). Multiaxial Diagnostic Inventory (Revised Edition). Sarasota, FL: Professional Resources Press, P.O. Box 15560, Sarasota, FL 34277-1560. Yossef S. Ben-Porath, Ph.D. is on the faculty of Kent State University and has conducted extensive research on the MMPI.