PAI Flashcards by Ian Abrams

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, neurological disorder
-Able to focus adequately for at least one hour

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How many items on the PAI?

344

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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)

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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

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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

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What are 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

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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

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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

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What PAI scales display a significant gender difference?

Antisocial Features (ANT) and Alcohol Problems (ALC)

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What are the scoring units for the PAI?

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

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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

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Discuss INF scale scores on the PAI

Infrequency scale

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

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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

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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.

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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.

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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+ - 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 - resasonable control over expression of anger and hostility 60-69T - impatient, irritable, quick-tempered 70T - chronic anger and/or free expression of hostility 83T - poor frustration tolerance, 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 person takes action.

Define and describe SUI on the PAI

Focused on suicidal ideation. 59T - 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. 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 life 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 need to make changes, has positive attitude about it, accepts responsibility. 53T-62T - generally satisfied with themselves. At the upper end, little motivation for therapy, 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 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 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.