ASSESSMENT - PAI

Question 1

What are the PAI Mean and SD?

Answer 1

Mean 50 for T scores and SD 10

Question 2

What is the clinical cut off score for the PAI

Answer 2

70 (98th percentile) = 2 SD above mean, Clinically significant

Question 3

What is the age range and reading level for the PAI

Answer 3

We need to know 18yrs and older and a 4th grade reading level to do the test

Question 4

What are the 4 validity scales in the PAI

Answer 4

NIM- Negative Impression Management
PIM- Positive Impression Management
INC - Inconsistency
INF - Infrequency

Question 5

What are the cut-offs for the 4 Validity Scales in the PAI

Answer 5

Positive Impression Management (PIM) – Cut off = 58
Negative Impression Management (NIM) – Cut off = 73
Infrequency (INF) – Cut off = 75
Inconsistency (ICN) – Cut off = 73

Question 6

How many clinical scales in the PAI?

Answer 6

Clinical and Treatment Scales

Clinical Scale x11 – cover most major psychopathology
Treatment Scales x5
Interpersonal Scales x4

Question 7

What is the clinical skyline in the PAI?

Answer 7

The clinical cut off scores

Clinical Skyline = scores that are 2 SD above the mean for a clinical population

o It is rare for general population to cross the skyline

Question 8

What are the scoring levels for the PAI

Answer 8

Scores up to 59 (within 1 SD) = AVERAGE

Scores 60 – 69 = MILD

Scores 70+ (2 SD) = CLINICAL

Question 9

What is the PAI Useful for?

Answer 9

Can be a comprehensive Ax to identify what might be going on, if presenting
problem is unclear

Question 10

Q: Someone scores 40 on the PIM - what doesn’t that mean?

Answer 10

Is that person faking goo faking bad profile not valid - no concerns with PIM his questions are inconsistent - answer no concerns

Question 11

Q;Validity scale 88 for INC what does that mean? -

Answer 11

Client responded INC manner; client responded inc to that session; client has some INF choices; client is faking bad; the whole profile is invalid - answer is he responded inconsistently and you would asks questions - you can only say its inconsistent - you can’t say it cancels the whole PAI

NOT OBVIOUSLY INVALID BECAUSE SOMEONE HAS AN ELEVATED SCORES -

You need to understand 50-59 etc doesn’t apply for validity scales they have specific cut offs

It seems the person has endorsed more positive more than average

Question 12

Q; You have been referred someone for a psych assessment because they are being treated for an accident and they have a minor injury and the client is saying they have pain and can’t work

Answer 12

The board likes to trick you - into seeing a client who is referred by a Dr who had an accident and their rehab Dr is wondering about their psychological state and why are you doing the PAI to see whether the person is malingering; to make a comprehensive assessment of clients personality (it’s really psychopathological and personality) - to see whether the disability os valid; to give an objective assessment for the dr, or to formulate accurately the clients problems?

You can’t formulate the client’s problems from this scale? - You are not an investigator - no one has told you about malingering

They have been referred for a psych assessment - have you been asked to give an opinion of the neck injury??? NOOOOO stay with the question - you are doing it to ensure you do a comprehensive assessment of the client

Question 13

1. Q: What if a client spends a long time answering questions and she is asking a lot of questions what’s the best way to respond to her?

To help her understand questions; no the PAI because it will take too long;
Ask the client to read out loud to check reading level;
Tell her to ignore the first 2 and answer the ones she can understand;
or continue explaining the meaning to help her understand?

Answer 13

Ans : ask her to read them out aloud- what to do next?

Question 14

Q: what if a client score 60-69 on all of the subscales on DEP;

1. They are avg;
2. Extreme end of the scale;
3. That the client has mild symptom of depression ;
4. That the client is suffering from trauma;
5. The client needs anti d’s

Answer 14

3.Ans; mild transient

Question 15

Q If someone has drug difficulties what would you look at how would you know people are improving in symptoms -

Answer 15

drug scale score elevated to average etc -

they will play around with the different ranges for the PAI and they will give you extreme ranges

If they fake dyslexia- reading ability is not consistent with his school - there’s not much you can say

Question 16

What does it mean if someone has a low score for resistance (RXT) to treatment?

Answer 16

IF THEY ARE AT THE BOTTOM OF THE GRAPH - the only conclusion you get RXT to treatment is high…they will be hard to work with if below they want help LOW RESITANCE IS THEY WANT HELP - if normal population - if they score avg or 1SD above mean why would they want treatment

Compare to normal population first if DEP is high not only severe for normal but score is high enough for a hospitalized sample too

Question 17

What is the rule of thumb for the PAI in relation to standard and clinical norms?

Answer 17

RULE OF THUMB - if already 1 SD above for clinical pop also gives you an idea of treatment - if you can ethically and safely -ALWAYS START WITH NORMS - IF CLINICAL YOU WOULDN’T BE TREATING IN A PRIVATE PRACTICE e.g. a dr would not treat an emergency liver problem

Question 18

What happens if you are working for the Aust govt and you are trying to do the PAI for people who have applied to spend 2 years in the antarctic doing some research and you want to see which people are more suited to survive - what sort of norms would you use?

Answer 18

The 2pt scales, clinical scales only, look at multi-dimension scores of quadratic; norms for general population and look at validity scaled only….A USE NORMS FOR GENERAL POPULATION

The board will make up things that sound scientific or complex for like an infrequency (most of these questions are bogus WTF answers) its likely you can cross that answer out - if it doesn’t make sense do not choo

Question 19

What you do need to know for the exam…….

Answer 19

Don’t need to worry about how to score for exam

WHAT YOU NEED TO KNOW IS

FULL SCALE PROFILE (called PAI profile

T scores mean of 50 and SD 10

Over 2 SD scores above the mean are 96%tile and plus - only 3-4% population above that - a small percentage will score above 70

What does that tell you when someone scores 70 and above

Clinical scales would mean clinical problems - for depression this person has symptoms on the clinical range likely to meet the criteria for MDD

What PAI also has is some subscales eg depression/ cognitive/affective and physiological side of depression you can see if they are elevated in these areas

Same with anxiety cognitive/affective and physiological side

They will tell you scale they want you interpret

Wont ask about sub-scales - will ask about SCALES

DIFFERENT CUT OFF SCORES for impression mgt

Check the score for 50-59 are considered average - 49 - 58 in the average range

They will give you obvious scores to interpret

Scores up to 40-59 considered average range - 58 for anx considered average

Scores 60 - 69 70 anx dep etc person has mild symptoms or mild prob alcohol and drug use (board calls transient symptoms = mild symptoms)

70 and above are clinical symptoms - people are in the clinical range above 70 for Dep etc CLINICAL PROBLEMS

2 SD above the line for the community - 50 mean and 2 sd will be 70 so only 4% of the population will score 70 and above

What happens when someone score 70 and above - the focus of comparisons shifts to the CLINICAL NORMS

If they score higher that 2SD’s 70 COMPARE TO clinical population - you LOOK AT THE CLINICAL SKYLINE

CLINICAL SKYLINE FOR DEPRESSION is 96 represents a score that is 2 SD’s above the clinical mean of a clinical population e.g. at a psych hospital a psych population will be a lot higher - mean of the clinical population is 76 (depression) eg depression is showing you 2 SD’s above a clinical population

Look at all the scores for community 70

Then I look compared to the clinical population

Have they crossed the clinical skyline

In the example the clinical skyline for suicide is 101 and he is above that - he has crossed the clinical skyline - even compared to a psych hospital her is higher - BIG RISK FOR SUICIDE almost 3SD above the mean for a clinical population

If they break the clinical skyline things are more severe

First impression of this guy is that he is suicidal - would you test this guy in outpatients in private practice NOOOOO he needs hospitalization - RISK Management is not enough

You can not work with a guy with high SUICIDE, DEPRESSION AND DRUG ISSUES in private practice - don’t allow your bosses to force you to work with this type of patient

Most of the questions for PAI - someone score in whatever range for anxiety or alcohol what does that mean - they can either give you a score in the mild or clinical range

Someone scores btw 50 and 59 on all of the clinical scales what does that mean

Know the brackets

You don’t need to remember the cut-offs for impression mgt validity