Beyond Rare-Symptoms Endorsement: a Clinical Comparison Simulation Study Using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) with the Inventory of Problems-29 (IOP-29)

  • Luciano GirominiEmail author
  • Sharon Carfora Lettieri
  • Salvatore Zizolfi
  • Daniele Zizolfi
  • Donald J. Viglione
  • Emanuela Brusadelli
  • Barbara Perfetti
  • Daniela Angiola di Carlo
  • Alessandro Zennaro


To date, the MMPI-based, rare-symptom detection strategy is considered one of the most effective ones in symptom validity assessment. Because many of the items of the Inventory of Problems-29 (IOP-29) were designed specifically to provide incremental validity over the MMPI F scales, this study tested whether using the IOP-29 in combination with the MMPI-2 would provide higher classification accuracy compared to using either instrument alone. A total of 155 Italian adult individuals contributed to this study. About half (n = 93) were experimental malingerers (expMAL) instructed to simulate depression without being detected as feigners. The others were either (a) depressed patients in treatment (n = 36) or (b) individuals evaluated for possible malingering associated with work-related stress and considered to be genuinely affected by depression (n = 26). All were administered the Italian versions of both the MMPI-2 and the IOP-29. As expected, both instruments were highly effective in discriminating feigned from bona fide depression, with AUC values ranging from .77 to .90. More importantly, when entering the IOP-29 after each of the MMPI-2 scales under consideration (i.e., F, Fb, and Fp), the logistic regression models predicting group membership (0 = patient; 1 = expMAL) improved significantly. Likewise, each of the three MMPI-2 scales under consideration also significantly improved the prediction of group membership, when entered after the IOP-29. These findings thus indicate that using the MMPI-2 together with the IOP-29 could provide incremental validity over using either instrument alone, when testing depression-related complaints.


IOP-29 MMPI-2 Malingering Depression Validity 



We thank Lucrezia Frinco for her help in the data collection.

Compliance with Ethical Standards

Conflict of Interest

Luciano Giromini and Donald J. Viglione declare that they own a share in the corporate (LLC) that possesses the rights to Inventory of Problems. The other authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Luciano Giromini
    • 1
    Email author
  • Sharon Carfora Lettieri
    • 1
  • Salvatore Zizolfi
    • 2
  • Daniele Zizolfi
    • 3
  • Donald J. Viglione
    • 4
  • Emanuela Brusadelli
    • 5
    • 6
  • Barbara Perfetti
    • 6
  • Daniela Angiola di Carlo
    • 6
  • Alessandro Zennaro
    • 1
  1. 1.Department of PsychologyUniversity of TurinTurinItaly
  2. 2.Private PracticeComoItaly
  3. 3.Faculty of Medicine and SurgeryUniversity of InsubriaVareseItaly
  4. 4.Alliant International UniversitySan DiegoUSA
  5. 5.University of Milano-BicoccaMilanItaly
  6. 6.UO di Medicina del LavoroASST-RhodenseGarbagnate MilaneseItaly

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