PAI Flashcards
Four conditions to be able to take PAI?
- 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
How many items on the PAI?
344
What is the breakdown of scales on the PAI?
- 4 validity
- 11 clinical
- 5 treatment
- 2 interpersonal = 22 scales
- 10 full scales contain conceptually derived subscales (31 subscales)
What are the Validity Scales on the PAI and what do they measure?
- ICN: Inconsistency
Problems with attn/concentration
- INF: Infrequency
Idiosyncratic / random response - NIM: Negative Impression Management
- PIM: Positive Impression Management
What are the Clinical Scales on the PAI?
- 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
What are the Treatment Consideration scales on the PAI and the two Interpersonal scales?
- AGG: Aggression
- SUI: Suicidal ideation
- STR: Stress
- NON: Nonsupport
- RXR: Treatment rejection
- DOM: Dominance
- WRM: Warmth
What are the Supplemental Indicators on the PAI and what do they mean?
- 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
What does a skyline mean regarding PAI scores?
- A profile skyline indicates a score 2 SDs above the mean in a combined inpatient/outpatient clinical sample
What PAI scales display a significant gender difference?
Antisocial Features (ANT) and Alcohol Problems (ALC)
What are the scoring units for the PAI?
Linear T Scores = M(50), SD(10)
Discuss ICN scale scores on the PAI
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
Discuss INF scale scores on the PAI
Infrequency scale
75T= invalid. The patient did not respond appropriately to item content.
Discuss NIM scale scores on the PAI
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
Discuss the Malingering index on the PAI
- 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.
Discuss the Rogers Discriminant Function on the PAI
- 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.
Discuss PIM scale scores on the PAI
Positive impression management
68T= invalid profile
Discuss the Defensiveness Index on the PAI
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.
Describe the Cashel Discriminant Function on the PAI
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
Define and describe SOM on the PAI
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.
Define and describe ANX on the PAI
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.
Define and describe ARD on the PAI
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
Define and describe DEP on the PAI
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
Define and describe MAN on the PAI
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.
Define and describe ALC on the PAI
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
Define and describe DRG on the PAI
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
Define and describe AGG on the PAI
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.
Define and describe SUI on the PAI
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.
Define and describe STR on the PAI
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
Define and describe RXR on the PAI
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
Define and describe DOM on the PAI
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
Define and describe WRM on the PAI
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.
