PAI

Question 1

What is the PAI used for?

Answer 1

PAI is a multi-scale, self-report test of personality. It is used to provide information relevant to clincial diagnosis, treatment planning, and screening for psychopathology.

Question 2

What is the age range for the PAI?

Answer 2

18 years +

Question 3

What are the validity scales on the PAI?

Answer 3

1. Inconsistency Scale (ICN) = degree to which respondents answer simila questions in different ways
2. Infrequency Scale (INF) = degree to which respondents rate extremely bizarre or unusual statements as true e.g. careless of random responding
3. Negative Impression Management (NIM) = degree to which respondents describe themselves in a negative/overly negative light
4. Positive Impression management (PIM) = degree to which respondents describe themselves in a positive/overly positive light

Question 4

What does the Somatic Concerns Clinical Scale Measure?

Answer 4

SOM = physical concerns/complaints.

Subscales = Conversion, Somatisation, Health Concerns

Question 5

What does the Anxiety Clinical Scale measure?

Answer 5

ANX = general feelings of tension, worry and nervousness

Subscales = Cognitive, Affective, Physiological

Question 6

What does the Anxiety Related Disorders Clinical Scale measure?

Answer 6

ARD = more specific anxiety symptoms that relate to different categories of anxiety disorders

ARD subscales = Obsessive-Compulsive, Phobias, Traumatic Stress

Question 7

What does the Depression Clinical Scale measure?

Answer 7

DEP = general feelings of worthlessness, sadness, and lethargy

Subscales = Cognitive, Affective, Physiological

Question 8

What does the Mania Clinical Scale measure?

Answer 8

MAN = level of high energy and exciteability

Subscales = activity level, grandiosity, irritability

Question 9

What does the Paranoia Clinical Scale measure?

Answer 9

PAR = suspiciousness and concern about others harming them

Subscales = hypervigilance, persecution, resentment

Question 10

What does the Schizophrenia Clinical Scale measure?

Answer 10

SCZ = unusual sensory experiences, bizarre thoughts, and social detachment

Subscales = psychotic experiences, social detachment, thought disorder

Question 11

What does the Borderline Features Clinical Scale measure?

Answer 11

BOR = problems with identity, emotional instability, and problems with friendships

Subscales = affective instability, identity problems, negative relationships, self-harm

Question 12

What does the Antisocial Featues Clinical Scale measure?

Answer 12

ANT = level of cruel/criminal behaviour and selfishness

Subscales = antisocial behaviours, egocentricity, stimulus seeking

Question 13

What does the Alcohol Problems Clinical Scale measure?

Answer 13

ALC = problems with excessive drinking

Question 14

What does the Drug Problems Clinical Scale measure?

Answer 14

DRG = problems with excessive recreational drug use

Question 15

What are the Treatment Consideration Scales?

Answer 15

1. Aggression = different kinds of aggressive behaviorus towards others (subscales = aggressive attitude, verbal aggrssion, physical aggrssion)
2. Suicidal ideation = frequency and severity of suicidal thoughts and plans
3. Stress = controllable and uncontrollable hassles and stressors repored by client
4. Nonsupport = how socially isolated a respondent feels, and how little support the respondent repors having
5. Treatment rejection = measures attributes related to psychological treatment adherance; motivation, willingness to accept responsibility, openness to change and new ideas

Question 16

What are the interpersonal scales on the PAI?

Answer 16

Dominance = degree to which respondent acts dominant, assertive and in control in social situations (low scores = submissiveness)

Warmth = degree to which a respondent acts kind, empathic, and engaging in social situations, assesses interest in supportive and empathic social relationships

Question 17

How does the PAI assess both breadth and depth of constructs measured?

Answer 17

Depth of content coverage = PAI includes items that address the full range of severity (mild to more severe items)

Breadth of content coverage = PAI includes differents signs of a disorder e.g. physiological, cognitive and affective signs/items

Question 18

When introducing the PAI for informed consent, what should be covered?

Answer 18

-Nature and purpose of the PAI
-Parameters of the assessment and how information will be obtained and used
-Time taken, location, fees
-When information will be shared and with whom
The test is standardised so results are compared to those of others in similar circumstances e.g. treatment, or pre-employment

Question 19

What should be considered to assess clients for self-report administration?

Answer 19

• Are clients by the nature of their disorder confused, disoriented, distractible, or manifesting extreme psychomotor retargation or agitation
• Cognitive abilities compromised by the effects of AOD intoxication or withdrawal, or disorientation from neurological deficit or disease
• Physical or sensorimotor deficits e.g. visual acuity, motor weakness in dominant hand might impact ability to complete the test
• Reading level of at least a 4th grade level

Question 20

How should PAI test feedback be given?

Answer 20

• Review the nature of the test e.g. test norms etc
• Feedback on the client’s/collaborative assessment questions formed at the beginning
• Findings that are more positive in nature and those that the client is more likely to be acknowledged by the client
• Findings that the client may have less insight too
• Present all findings with recurring themes within the data and tie to the client’s goals for assessment and treatment
• End session with client summarising their interpretation of feedback and describing their subjective impressions of the session

Question 21

How does the PAI scoring work?

Answer 21

The PAI scoring is based on t scores = mean of 50t and SD of 10t.

Each item receives a score of 0,1,2,3 depending on what the client endorsed. Items for scales are summed for raw scores (or items of subscales are summed then summed to form a full scale).

Approximate percentile equivalents =
1 SD (60t) = 63rd percentile (borderline)
2 SD (70t) = 96th percentile (clinical)

Question 22

How is the inconsistency scale scored?

Answer 22

10 item pairs are compared:

• The first 8 pairs = consistent responding would result in item scores that are similar –> to score, the absolute value of any difference between the scores of the item pair adds cumulatively to the raw score of the ICN
• The last 2 pairs = consistent responding would result in item scores being opposites for the pairs (e.g. 0 and 3) –> to score, subtract one of the item scores from 3; this new number is then subtracted from it’s pair and this difference is added cumulatively to the raw score of the ICN

Question 23

After completing and scoring the PAI, what is the first step in interpretation?

Answer 23

Assessing the potential of profile distortion (the validity of the profile):

• Do the results provide an accurate reflection of the experience of the respondent or whether they are distorted in some way?
• Factors before the assessment arae considered here too e.g. nature of referral, intended use of results, utimate recipients of the test information

Question 24

When would you use a clinical reference group for interpretation?

Answer 24

Community versus clinical comparisons

• T scores of 70t+ = unusual degree of problem/symptoms compared to the general population = likely indicating a problem of clinical significance and a shift in contextual reference point to clinical focus would be appropriate
• PAI profile clinical skyline = a reference point for scores that are unusual in a clinical setting = the clinical skyline is 2 SDs from the mean of a CLINICAL population (which isn’t necessarily 50t and will vary on each scale)

Question 25

How should individual scales be interpreted?

Answer 25

- By examining the: full scale score (or scores if comparing to different normative contexts), subscale scores, and individual scale items - Assuming little/no profile distortion, the initial focus should be on those full scales that obtain scores of 70t of greater = representing pattern of difficulties that merit clinical attention, and comparing these to clinically referenced standard scores identifies which elevations are most central to the profile - Interpretation of the subscales clarifies meaning of full-scale evaluations e.g. there may be a lack of supporting data from subscale configuration to support a diagnosis (DEP-A is elevated, but DEP-P and DEP-C are not) - Interpretation of individual items is imporant for specific difficulties experienced by the respondent e.g. ARD-P includes single items that tap commonly geared objects as well as social phobia and public situations. Also imporant to analyse the 27 critical items (delusions, hallucinations, self harm potential)

Question 26

What methods of interpreting profile configuration are possible?

Answer 26

1. Profile code typs = classifying a profile configuration by its two-point code (two most elevated scales). This is the most simple and traditional approach but meaningful differences can be lost e.g. identifical codes for two people but very different responses, and very small differences between the scales can question reliability 2. Mean profile comparison = comparing PAI profile to those who share particular similarities such as diagnosis or symptoms. But comorbidity among emotional disorders and variations in diagnostic practice may not fully capture elements of the PAI reflecting that disorder. 3. Conceptual indexes = configural rules on theory-driven hypotheses or clinical observations e.g. malingering and defensiveness indexes, or clinical decision making configural indexes such as violence potential, suicide potential, and treatment process. But these need cross-validation research but may be useful in combination with other strategies. 4. Acturaial decision rules = applying multivariatae functions to combine scale scores and identify formulas for decisions e.g. for defensiveness, malingering and substance abuse denial. But this requires large sample sizes to construct the functions and only a limited amount have been develope.

Question 27

What do scores of 70t mean?

Answer 27

``` 70t = a clincial score for clinical scales 70t = a significant score for other scales ``` 60t-69t = might mean mild difficulties/non-serious difficulties/transient symptoms

Question 28

If someone scored above the clinical skyline for depression, what does that mean?

Answer 28

They scored 2 SDs above the mean for depression in a clinical population

Question 29

If someone scored 60-69 on anxiety and 70-79 on depression, how would you interpret these scores?

Answer 29

- Transient/mild anxiety symptoms | - Clinical symptoms of depression

Question 30

If someone did the PAI and received an 84 on the PIM scale, what can you interpret from this?

Answer 30

The client seems to be representing themselves as doing better than what they are.