PAI Hx/Tests
What does PAI stand for and who developed it? And what is some basic info about when published, number of items, test length, and age
Personality Assessment Inventory by Morey
1991, 344 items, 4 likert scale, 50-60mins, 18+
SOM
Somatic Complaints - physical functioning and health, not illness, psychological reaction to it
Somatic
SOM-C (Conversion - sensory/motor, perception & headaches - neuro-sensory)
SOM-S (Somatization) - routine complaints GI, back pain
SOM-H (Health concerns) - degree to which focused on
SOM
60 - maybe health problems, bothering you (older people)
70- significant concerns
80 - preoccupied health concerns
SOM-C (Conversion - 60-70 check for stroke/MS)
AGG
Aggression & Anger
AGG-A attitude - aggressive approach to life
AGG-V Verbal
AGG-P Physical - past + current attitudes toward physical behavior
Aggression
AGG
AGG-A 60's easily frustrated, 70's prone to anger
AGG-V: 70's descriptive verbal abuse
Steps of Validity?
1) Omissions
2) Nonsystematic Distortion
3) Systematic Distortion (over/under reporting)
Step 2
Nonsystematic Distortion: ICN & INF
Step 3
Systematic Distortions:
1) Negative Responding: NIM/MAL/RDF
2) Positive Responding: PIM/DEF/CDF
PIM & T scores
Positive impression management
moderate: 57T-68T
overly positive: >65T
What is the psychometric power of less questions asked on PAI but ultimately more questions are asked? And what is the challenge is someone is indecisive?
Using a 4 point likert rating scale (not true, slightly true, mainly true, very true)
Some distortion can happen if youre not familiar with answering in this nature or if you're indecisive
ANX
Anxiety - tension
Anxiety
ANX-C (Cognitive) - worry, ruminating, bad will happen
ANX-A (Affective) - nervous, tension
ANX-P (Physiological) - racing heart, sweaty palms
ANX
60: stress
70: significant anxiety
80: overwhelming anxiety
SUI
Suicidal Ideation - thoughts of death and suicide
Suicidal Ideation
SUI:>70 recurrent suicidal thoughts
Step 1
Omission - enough items? If skipped 18 or more ask client to review & fill. If more than 20% unanswered, not valid (need 80% in each scale)
ICN
Inconsistency - pairs with strong norm correlations
What 2 things does step 3 try and measure/distinguish between that the MMPI does not? And give an example of each
effortful (malingering) and non-effortful (depression)
DEF
Defensive Index, pairs you don't expect, ie depressed but resistant to treatement
The PAI scales are made up of?
4 validity scales
11 Clinical scales
5 Treatment Scales
2 Interpersonal scales
ARD
Anxiety Related Disorders
Anxiety Related Disorders
ARD-O (Obsessive Compulsive) - rituals, contamination fear, perfectionism
ARD-P (Phobias) - fear of heights, small spaces, social
ARD-T (Traumatic Stress) - have had trauma, expect with PTSD, nightmares, sudden/anxious reaction
ARD
ARD-P (phobias):
60-70 acknowledge but not disabling nervousness, not big impact
70 impairment of general functioning
<35 fearless, reckless
STR
Stress (family, impacting you, fin?)
Stress
STR
60's moderate stress
> 70 lots of stress
Do you interpret the subscales when elevated or not elevated?
Because there is no item overlap on scales you can interpret even when not elevated
INF
Infrequency - infrequently endorsed items but not psychopathological 1) random responding 2) idiosyncratic/read items in an unusual way
ie my favorite poet is Raymond Kertezc or my favorate hobbies are archery and stamp collecting
NIM & T scores
Negative impression management: measures genuine psychopathology, predicted profile with norm samples,
80T some distortion, check effortful or noneffortful
90-100T intentional distortion
CDF
Cashel Discriminant Function, pure measure of effortful distortion, difficult to manipulate, not psychopathology
How were the scales developed?
Informed rational basis to create clarity and remove redundancy and bias issues
Used psychopathology research - ie research suggests depression cluster of 3 subscales cognitive, affective, physiological
DEP
Depression
Depression
DEP-C (Cognitive) - depression, helpless, hopeless, low self esteem
DEP-A (Affective) -unhappy, sad
DEP-P (Physiological) - lack of sleep, low energy
DEP
60: unhappy, dysphoria
70: prominent dysphoria, some disorder (adjustment)
80: MDD
DEP:C <40 grandiosity, now low self esteem
All 3 subscales >70T = MDD
Chronic (BOR high) Situational (STR high, BOR low)
NON
nonsupport - perception of lacking support
Non support
NON
60: few close relationships
70: little support
Interpretation Steps
Valid?
Interpretation: scales/subscales, overlays, codetypes, clusters, structural summary
When is ICN probably distorted
61T
MAL
Malingering index. Pairs you wouldn't expect - nature of distortion, empirically more common to fake bad
ie. PAR-P:PAR-H persecuted but trust
If all 3 PIM/DEF/CDF elevated then?
Can it be administered to groups? Can it be done remotely?
Yes - individuals and groups! Yes, remote! No special instructions, just rapport to facilitate valid data
MAN
Mania
MAN-A (Activity Level) - wide variety, over involved
MAN-G (Grandiosity) -
MAN-I (Irritability)- low frustration tolerance
MAN
60: moody, impulsive
70: hypomania, hypomanic drive
80: non functional
MAN-A: 60 high level, 80 nonfunctional (disruptive confusion)
MAN-G: 60-70 optimistic politicians, 70 narcissism, self centered, < low = low self esteem
MAN-I 60 impatient, 70 not patient, intolerant
RXR
Treatment Rejection: not willing to engage treatment, denial, lacking introspection
Treatment Rejection
RXR
50: no problems, don't need help
<50: willing, need assistance, help
60-70: I don't need it at all "never" I'm find, protesting too much
The clinical sample blue line on the graph is called?
The clinical skyline
When is ICN probably distorted and marked/elevated
Probably distorted: 61T
Marked/elevated: 73T
RDF
Rogers discriminant function, empirically developed formula as pure measure of malingering/effortful
If PIM and DEF are elevated but CDF is not then?
Covert positive responding, non-effortful
Nature of the PAI items
fewer questions, no overlap between scales, 4th grade reading level
PAR
Paranoia
Paranoia
PAR-H (Hyper-vigilent)
PAR-P (Persecution) - impeding efforts
PAR-R (Resentment) - not treated fairly, thin skinned
PAR
60?
70 suspicious, hostile, not delusional
80: delusional
PAR-H: 60 doesn't trust everyone, skeptical 70 higher suspicion, personality disorder range
PAR-P 60 jealousy 70 delusional, others to you
PAR-R easily insulted, 70 blaming others
Interpersonal Scales
DOM/WRM temperament patterns, how deal with world
How were clusters derived?
factor analytically derived, 10 modal profiles
When is INF probably distorted and marked/elevated
Probably distorted: 71T
Marked/elevated: 75T
NIM: mix of effortful and non effortful
MAL: more effortful
RDF: pur measure of malingering/effortful
Levels of effortful and non effortful in PIM/DEF/CDF?
PIM - mix of both
DEF - more effortful
CDF - pure effortful
What is PAS & explain it
Personality Assessment Screener, 22 items of PAI, measure of 10 elements, P scores to predict PAI, 50 (moderate) = 50% chance clinical elevation higher than 70T, raw score 19 (moderate) Identify's 85% with elevated PAI clinical scales
Simple, dumb, quick and supported screener
SCZ
Schizophrenia
Schitzophrenia
SCZ-P: Psychotic Experience - positive symptoms - hallucinations, delusions
SCZ-S Social Detachment- flat affect, apathy, negative symptoms
SCZ-T Thought Disorder- disruptive thought processing, loose tangential thinking
SCZ
60's: unconventional, withdrawn, eccentric
70's: alienated from others
80's: active psychotic process
DOM
Dominance - how much desire control
Dominance
DOM
<40 passivity
60 self confident
70 really important to you to need to be in control
When scores elevated?
80T's
If INF is elevated but not ICN then?
Idiosyncratic, weird and unusual way of reading items
Levels of pathology in NIM/MAL/RDF
MAL: moderate pathology
RDF: minimal pathology
Levels of psychopathology in PIM/DEF/CDF?
PIM: strong
DEF: moderate
CDF: minimal
PAI-A & explain
BOR
Borderline - DSM (personality pattern of emotional dysregulation)
Borderline
BOR-A Affective Instability - rapid mood shift, quick anger and anger problems
BOR-I Identity Problem - confused, diffuse sense of self, loss sense of who they are, unclear purpose
BOR-N Negative Relationships - chaos, intense
BOR-S Self Harm - act out, impulsive, self destructive
BOR
60: emotional, rough relationships
70's: emotionally moody (up and down), impulsive, difficult relationships
80's: severe level of disfunction
BOR-I 55T college students
If 3 to 4 elevated probably meets criteria for Borderline Personality Disorder (BPD)
WRM
Warmth in relationships
Warmth
WRM
<40 detached
50av
60 > focused on relationships
70: neediness
What elevation T score to consider with Codetypes?
70T
If both ICN and INF elevated then what?
What does it mean if all 3 NIM/MAL/RDF are elevated?
Then malingering
Examples of effortful and noneffortful test data
RXR/PIM Noneffortful: Optimistic, pollyannaish, grandiose, perception style, MAN-G, RXR
DEF/CDF Effortful: intentional/denial
ANT
Antisocial (psychopathy - calloused/not empathetic)
Antisocial
ANT-A: antisocial behavior - rule breaking
ANT-E: egocentricity - callousness, lack of empathy
ANT-S: stimulus seeking - risk seeking, novelty, reckless
ANT
60's: risk taking, impulsive
70's: impulsive, hostility
80's: more ability to use and abuse others
ANT-A: 70's authority problems
ANT-E: 60's self centered, 70's little regard for others
ICN elevated but not INF
attention and reading problems, appropriate effort
If NIM & MAL high but RDF normal then?
Covert negative responding, non-effortful
ALC/DRG
Drug and alcohol problems
Alcohol and Drug
ALC & DRG no subscales
ALC/DRG
70's: substance abuse issues
80's: dependence > Chronic + significant
Examples of effortful and noneffortful test data
NIM Noneffortful: negative perception style, DEP/BOR
MAL/RDF Effortful: Malingering