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Flashcards in PAI Deck (31)
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1

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

2

How many items on the PAI?

344

3

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)

4

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

5

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


6

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

7

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


8

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

9

What PAI scales display a significant gender difference?

Antisocial Features (ANT) and Alcohol Problems (ALC)

10

What are the scoring units for the PAI?

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

11

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

12

Discuss INF scale scores on the PAI

Infrequency scale

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

13

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

14

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.

15

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.

16

Discuss PIM scale scores on the PAI

Positive impression management

68T= invalid profile

17

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.

18

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

19

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.

20

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.

21

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

22

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

23

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.

24

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

25

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

26

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.


27

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.

29

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

30

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


31

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