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Rehab Counseling > PAI > Flashcards

PAI Flashcards

1
Q

Four conditions to be able to take PAI?

A

-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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2
Q

How many items on the PAI?

A

344

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3
Q

What is the breakdown of scales on the PAI?

A
  • 4 validity
  • 11 clinical
  • 5 treatment
  • 2 interpersonal = 22 scales

-10 full scales contain conceptually derived subscales
(31 subscales)

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4
Q

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

A

-ICN: Inconsistency
Problems with attn/concentration

-INF: Infrequency
Idiosyncratic / random response

  • NIM: Negative Impression Management
  • PIM: Positive Impression Management
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5
Q

What are the Clinical Scales on the PAI?

A
  • 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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6
Q

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

A
  • AGG: Aggression
  • SUI: Suicidal ideation
  • STR: Stress
  • NON: Nonsupport
  • RXR: Treatment rejection
  • DOM: Dominance
  • WRM: Warmth
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7
Q

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

A

-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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8
Q

What does a skyline mean regarding PAI scores?

A

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

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9
Q

What PAI scales display a significant gender difference?

A

Antisocial Features (ANT) and Alcohol Problems (ALC)

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10
Q

What are the scoring units for the PAI?

A

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

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11
Q

Discuss ICN scale scores on the PAI

A

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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12
Q

Discuss INF scale scores on the PAI

A

Infrequency scale

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

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13
Q

Discuss NIM scale scores on the PAI

A

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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14
Q

Discuss the Malingering index on the PAI

A

-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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15
Q

Discuss the Rogers Discriminant Function on the PAI

A

-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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16
Q

Discuss PIM scale scores on the PAI

A

Positive impression management

68T= invalid profile

17
Q

Discuss the Defensiveness Index on the PAI

A

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.

18
Q

Describe the Cashel Discriminant Function on the PAI

A

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

19
Q

Define and describe SOM on the PAI

A

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.
20
Q

Define and describe ANX on the PAI

A

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.

21
Q

Define and describe ARD on the PAI

A

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

22
Q

Define and describe DEP on the PAI

A

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

23
Q

Define and describe MAN on the PAI

A

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.

24
Q

Define and describe ALC on the PAI

A

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

25
Q

Define and describe DRG on the PAI

A

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

26
Q

Define and describe AGG on the PAI

A

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.

27
Q

Define and describe SUI on the PAI

A

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.

29
Q

Define and describe STR on the PAI

A

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

30
Q

Define and describe RXR on the PAI

A

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

31
Q

Define and describe DOM on the PAI

A

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

32
Q

Define and describe WRM on the PAI

A

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.

Rehab Counseling (15 decks)

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