PAI

Question 1

Four conditions to be able to take PAI?

Answer 1

• 4th grade (approx.) or higher reading level
• Borderline or higher IQ
• Not psychotic or compromised by alcohol, drugs, a neurological disorder
• Able to focus adequately for at least one hour

Question 2

How many items on the PAI?

Answer 2

344

Question 3

What is the breakdown of scales on the PAI?

Answer 3

• 4 validity
• 11 clinical
• 5 treatment
• 2 interpersonal = 22 scales
• 10 full scales contain conceptually derived subscales (31 subscales)

Question 4

What are the Validity Scales on the PAI and what do they measure?

Answer 4

• ICN: Inconsistency

Problems with attn/concentration

• INF: Infrequency
  Idiosyncratic / random response
• NIM: Negative Impression Management
• PIM: Positive Impression Management

Question 5

What are the Clinical Scales on the PAI?

Answer 5

• SOM: Somatic complaints
• ANX: Anxiety
• ARD: Anxiety-related DOs
• DEP: Depression
• MAN: Mania
• PAR: Paranoia
• SCZ: Schizophrenia
• BOR: Borderline features
• ANT: Antisocial features
• ALC: Alcohol problems
• DRG: Drug problems

Mnemonic: SAAD (MPS) BAAD

Question 6

What are the Treatment Consideration scales on the PAI and the two Interpersonal scales?

Answer 6

• AGG: Aggression
• SUI: Suicidal ideation
• STR: Stress
• NON: Nonsupport
• RXR: Treatment rejection
• DOM: Dominance
• WRM: Warmth

Question 7

What are the Supplemental Indicators on the PAI and what do they mean?

Answer 7

• Defensiveness Index
  Minimization of problems to deceive self/others
• Cashel Discriminant Function
  Intentional dissimulation that is probably defensive
• Malingering Index
  Pessimism or malingering
• Rogers Discriminant Function
  Also malingering
• ALC/DRG Estimated Score (2)
  Deception regarding substance use
• Suicide/Violence Potential Index
  Enhanced probability of violence or suicide
• Treatment Process Index
  Difficult treatment process

Question 8

What does a skyline mean regarding PAI scores?

Answer 8

• A profile skyline indicates a score 2 SDs above the mean in a combined inpatient/outpatient clinical sample

Question 9

What PAI scales display a significant gender difference?

Answer 9

Antisocial Features (ANT) and Alcohol Problems (ALC)

Question 10

What are the scoring units for the PAI?

Answer 10

Linear T Scores = M(50), SD(10)

Question 11

Discuss ICN scale scores on the PAI

Answer 11

Inconsistency scale

64-73T= carelessness, comprehension problems, confusion, possible idiosyncratic responding

>73T= invalid profile; inconsistent or inappropriate attention to item content
Random responding produces avg. of 73T

Question 12

Discuss INF scale scores on the PAI

Answer 12

Infrequency scale

75T= invalid. The patient did not respond appropriately to item content.

Question 13

Discuss NIM scale scores on the PAI

Answer 13

Negative impression management

73-84T=element of exaggeration is present

84-92T=distorted view of self, “cry for help”

>92T= trying to make self look bad; *possible* malingering, careless responding, extremely negative self-presentation

Question 14

Discuss the Malingering index on the PAI

Answer 14

• Consult when NIM is high.
  Made up of 8 indicators that are rare in community or clinical samples.

3+ lies >2 SD above the mean for a clinical sample, so this should raise questions.

5+ on malingering occurs when severe mental illness is feigned.

Question 15

Discuss the Rogers Discriminant Function on the PAI

Answer 15

• Developed to distinguish the PAI profiles of real psychiatric patients from individuals simulating psychopathology.

Mean= -1.00, SD= 1.0

>0 suggests malingering. Scores less than 0 suggest that no effort at negative distortion was made.

Question 16

Discuss PIM scale scores on the PAI

Answer 16

Positive impression management

68T= invalid profile

Question 17

Discuss the Defensiveness Index on the PAI

Answer 17

Comprised of eight configural features that tend to be observed more frequently in subjects trying to present a positive impression vs. community or clinical subjects.

>6 raises questions about faking good (overly defensive)

This index has limited sensitivity, so lower scores do not mean lack of defensiveness.

Question 18

Describe the Cashel Discriminant Function on the PAI

Answer 18

Index distinguishes between defensive and honest responding.

Derived in a study in which students/inmates were asked to answer PAI in a way that makes them look good, but is also believable.

160= positive distortion

Question 19

Define and describe SOM on the PAI

Answer 19

Somatic complaints

3 subscales: Conversion,
Somatization, Concerns

<59T - few bodily concerns

60-69T - some concerns.
Medical patients or elderly.

70T+ - significant impairment. Unhappy, pessimistic.

88T+ - a wide array of somatic
concerns involving several
biological systems. Probable
somatoform disorder, little
insight, poor prognosis.

Question 20

Define and describe ANX on the PAI

Answer 20

Experience and observable signs of anxiety

3 subscales: Cognitive, Affective,
Physiological

<59T - few complaints of anxiety

60-69T - some worry, sensitivity

70T+ - significant anxiety, worry, tension

91T+ - generalized impairment from anxiety, serious constriction in life, trouble meeting role expectations. Mild stressors could lead to crisis.

Question 21

Define and describe ARD on the PAI

Answer 21

Focus on symptoms and behaviors of specific anxiety disorders.
(If ANX elevated but not ARD, suggests nonspecific anxiety

3 subscales: Obsessive-
Compulsive, Phobias, Traumatic
stress

<59T - little distress

60T-69T - specific areas

70T+ - suggests impairment from an anxiety condition. Insecure, self-doubt, rumination

91T+ - broad impairment; turmoil, guilt-ridden, unable to control anxiety

Question 22

Define and describe DEP on the PAI

Answer 22

Focus on symptoms and experience of depression

3 subscales: Cognitive, Affective, and Physiological

>59T - few complaints about unhappiness/distress

60T-69T - some unhappiness, sensitivity, pessimism, doubt

70T+ - dysphoria, despondency, anhedonia, guilt

81T+ - MDE is very likely

Question 23

Define and describe MAN on the PAI

Answer 23

Items focus on affective, cognitive, and behavioral symptoms of mania and hypomania

3 subscales: Activity, Grandiosity, Irritability

>54T - few endorsed items related to mania or hypomania

55-64T - active, outgoing, ambitious, confident. Could be quick-tempered or hostile towards
upper end of this range

65-74T - restlessness, impulsivity, high energy. Seen as unsympathetic, hotheaded

75T+ - typically associated with hypomania, cyclothymia, or even mania.

Question 24

Define and describe ALC on the PAI

Answer 24

Problematic alcohol consequences/dependence features

-Obvious questions, so denial can suppress the scale

<59T - moderate, no problems

60-69T - regular drinking, possible adverse consequences

70T+ - responses generally suggest abuse; significant consequences likely with relationships and/or employment

84T+ - dependence, guilt, inability to stop, possible blackouts

98T+ - associated with severe dependence

Question 25

Define and describe DRG on the PAI

Answer 25

Problematic drug consequences, features \<59T - moderate, no problems 60-69T - regular use, possible adverse consequences 70T+ - responses generally suggest abuse; significant consequences likely with relationships and/or employment 80T+ - dependence and withdrawal, guilt, inability to stop, interference with functioning 90T+ - associated with severe dependence

Question 26

Define and describe AGG on the PAI

Answer 26

Characteristics and attitudes related to anger, hostility, and aggression. This includes verbal and physical aggression. Three subscales: Aggressive Attitude, Verbal Aggression, Physical Aggression \<59T - reasonable control over the expression of anger and hostility 60-69T - impatient, irritable, quick-tempered 70T - chronic anger and/or free expression of hostility 83T - poor frustration tolerance, the potential for aggression; fights, legal difficulties, occupational problems are common. \*If AGG-V is low and AGG-P is high, there is often little warning before a person takes action.

Question 27

Define and describe SUI on the PAI

Answer 27

Focused on suicidal ideation. 59T - the person has few or no thoughts about suicide and death 60-69T - person entertains periodic and transient thoughts of suicide, pessimistic and unhappy about future. Follow-up is desirable 70T+ - significant ideation; anx. or depressed, see selves as without support. "Cries for help." Careful evaluation is indicated. 84T+ - imminent plans for self-harm are likely; immediate evaluation is indicated. The person has little hope, feels unsupported, ineffectual, useless, bitter, despairing 101T+ - rare; morbid preoccupation with suicide. Evaluate immediately.

Question 28

Define and describe STR on the PAI

Answer 28

Items focus on the impact of current/recent stressors on family, health, employment, finances, and other areas. \<59T - life is stable, predictable, uneventful 60T-69T - some degree of stress due to difficulties in a major life area 70T - stress related to life difficulties is likely to be significant 77T-91T - perceives crisis in most living areas, powerless to control their life

Question 29

Define and describe RXR on the PAI

Answer 29

Attributes predictive of interest in and motivation to make changes of a psychological or emotional nature. \<42T - recognizes major difficulties in functioning and need for help 43T-52T - acknowledges the need to make changes, has a positive attitude about it, accepts responsibility. 53T-62T - generally satisfied with themselves. At the upper end, little motivation for therapy, the risk for termination 63T+ - person admits to few difficulties, no desire to change status quo. Probably not a therapy seeker; resists therapy

Question 30

Define and describe DOM on the PAI

Answer 30

Measures the extent to which a person is controlling and independent in personal relationships. s need for control is pronounced. Tend towards domineering, low tolerance for disagreement. Others see the person as self-important, overbearing, dictatorial

Question 31

Define and describe WRM on the PAI

Answer 31

Assess the extent to which a person is supportive and empathetic in relationships. opinions than most. 40T-59T - average 60T-69T - warm sympathetic, supportive, eager to be like. Hard to be critical and easy to forgive. Others may take advantage. 70T+ - doormat. Dependent, too trusting, and supportive of others for their own good.