Clinical Assessment: Personality Assessment Inventory (PAI) PSY 614 Instructor: Emily E. Bullock, Ph.D.

Introducing the PAI Developed by Leslie C. Morey in 1991 Self-administered, objective inventory of adult personality and psychopathology Provides information on critical clinical variables

Description 344 items 22 nonoverlapping full scales 4 Validity scales 11 Clinical scales 5 Treatment Consideration scales 2 Interpersonal scales

Development of the PAI Emphasized construct validation and included both rational and empirical scaling Took advantage of recent advances in psychometrics

Norms Standardized on 1,000 community-dwelling adults 18 and up Clinical norms based on sample of 1,246 College student norms are available but less representative

Reliability Median alphas for full scales are .81, .82, and .86 for the normative, college, and clinical samples, respectively. Median 4-week test-retest reliability across all three samples was .86. Mean absolute T-score change was 2 to 3 T-score points for most full scales.

Validity Convergent validity between clinical scales and measures of similar constructs is impressive. DEP and BDI (r = .81) ANX and STAI (r = .76) ANT and Hare PCL (r = .82) ALC and MAST (r = .89)

Administration For use with persons 18 and up 4th grade reading level Requires approximately 50 minutes Frequently administered in the Clinic early in treatment to clarify diagnostic issues

PAI Scoring Protocols can be scored in the Assessment Lab. Lab is equipped with software for computer-generated PAI Clinical Interpretive Reports

Meaning of T-scores T-scores have a M = 50 and SD = 10 and are based on the community sample norms. 84% of nonclinical respondents will have a T-scores below 60. T-scores above 70 represent a significant deviation from the norm (98th percentile).

Meaning of T-scores cont. The PAI-SP generates T-scores from two normative samples: normal adults and clinical patients. The profile “skyline” shows the score that is 2 SDs above the mean of the clinical sample (i.e., 98% of the clinical sample will fall below this skyline).

Introduction to PAI Interpretation The PAI Clinical Interpretive Report provides a starting point. Overreliance on computer-generated test interpretation is unethical. Additional interpretive information is contained in the PAI manual and interpretive guide.

Steps in the Interpretive Process Establish profile validity. Examine the Clinical Scales. Consider profile configuration. Interpret the Treatment Consideration and Interpersonal Scales. Check critical items.

Validity Scales Inconsistency (ICN) Infrequency (INF) Negative Impression (NIM) Positive Impression (PIM)

Clinical Scales Somatic Complaints (SOM) Anxiety (ANX) Anxiety-Related Disorders (ARD) Depression (DEP) Mania (MAN) Paranoia (PAR) Schizophrenia (SCZ)

Clinical Scales cont’d Borderline Features (BOR) Antisocial Features (ANT) Alcohol Problems (ALC) Drug Problems (DRG)

PAI Subscales Most of the Clinical Scales have subscales: Depression (DEP) Cognitive (DEP-C) Affective (DEP-A) Physiological (DEP-P) Subscale configuration helps us clarify the meaning on elevation on the Clinical Scales

Treatment Scales Aggression (AGG) Suicidal Ideation (SUI) Stress (STR) Nonsupport (NON) Treatment Rejection (RXR)

Interpersonal Scales Dominance (DOM) Warmth (WRM)

PAI Critical Items 27 critical items Indicate potential crisis situations and have very low endorsement in normal sample Designed to facilitate follow-up questioning