Personality Assessment Inventory Scales Research Articles

Temporal Stability of the Personality Assessment Inventory: Investigating Potential Predictors.

In this study, we explored the temporal stability of the Personality Assessment Inventory (PAI), which has not been comprehensively reexamined since it was first published. Our three specific aims were to determine the utility of PAI indicators of basic protocol validity (inconsistent responses [ICN] and highly unusual/unlikely responses [INF]) in identifying suspect responding; calculate the stability coefficients for each PAI scale and subscale across 3-, 6-, and 9-week spans; and explore whether profile stability across four measurements could be prospectively predicted. We administered the PAI to a sample of undergraduates (N = 579) at four separate timepoints. ICN and INF effectively identified likely attriters and inconsistent responders. All PAI full scales and subscales evidenced good test-retest reliability, with some small exceptions. Finally, all PAI clinical scales were correlated with profile instability although many of these correlations were no longer significant when controlling for mean clinical elevation of the profile. We interpreted these results as evidence for the utility of PAI validity scales, the temporal reliability of the PAI, and the role of psychopathology in response variability over time. We also discussed some preliminary evidence that this variability can be prospectively predicted, suggesting that it in part reflects substantive changes rather than random error variance.

Outcomes in post-acute sequelae of COVID-19 (PASC) at 6 months post-infection part 2: Psychological functioning

Objective: Limited research investigating the long-term psychological and emotional correlates of COVID-19 infection has been completed. The current study begins to address this limitation in patients experiencing Post-Acute Sequelae SARS-CoV-2 (PASC; e.g. “Long COVID”). Participants and methods: Participants were 43 consecutive neuropsychological outpatients diagnosed with PASC and who completed the Personality Assessment Inventory (PAI). The sample was predominantly female (n = 36) and white (n = 32). Effect sizes compared to the normative mean T scores and base rates of elevated (T > 69) scores were calculated. Results: PAI scales measuring somatic preoccupation and depression had large effect sizes and the highest base rates of scale elevations, with the mean T score at approximately the normative cutoff for clinical significance (T = 70). The Schizophrenia Thought Disorder subscale (SCZ-T) also had a large effect size and high base rate of elevation, likely reflecting cognitive concerns. Scales measuring anxiety had medium effect sizes. The other PAI scales generally had small to negligible effect sizes. There were no significant differences between hospitalized and non-hospitalized participants on the PAI. Conclusions: Overall, PAI scales measuring psychological distress, particularly somatic preoccupation and depression, were the most frequently elevated in the participants. The specific reasons for somatic preoccupation could not be determined in this study. Potential explanations include a vulnerability to distress in Long COVID patients, premorbid somatic preoccupation perhaps motivating these patients to seek clinical attention, or socioenvironmental factors leading some COVID patients to be somatically preoccupied with minor physiological changes and attribute those changes to COVID-19.

Personality in Autism Spectrum Disorder: Associations With Face Memory Deficit and Theory of Mind.

To examine the personality profiles of adults with autism spectrum disorder (ASD) using a standard personality assessment and to investigate the association between personality, ASD-related face memory deficit (FMD), and theory of mind (ToM). In a broader context, to examine whether there are distinct clinical phenotypes in the ASD population that have implications for personality development and treatment. Fifty-five adults with ASD and 22 neurotypical (NT) adults underwent a battery of neuropsychological tests, including measures of personality, face memory, and ToM. We compared ASD and NT groups in terms of their Personality Assessment Inventory (PAI) profiles. Additional analyses focused on the association between specific PAI scales and FMD. Performance on the Eyes Test was compared across groups and was examined in relation to FMD. Adults with ASD demonstrated significant elevations on several PAI scales compared with NT adults. The presence of FMD was associated with differing PAI profiles among the ASD adults. The ASD adults with FMD scored significantly higher on scales that are sensitive to positive impression management and treatment rejection and significantly lower on scales that are sensitive to borderline personality, anxiety, depression, schizophrenia, and stress. There was a significant association between performance on the Eyes Test and FMD in the ASD group. Adults with ASD have a unique personality profile. Further, ASD adults with FMD have reduced insight into their difficulties with emotional processing and may not be as sensitive as ASD adults without FMD to the emotions of others.

Replication and cross-validation of the personality assessment inventory (PAI) cognitive bias scale (CBS) in a mixed clinical sample

Objective: This study is a cross-validation of the Cognitive Bias Scale (CBS) from the Personality Assessment Inventory (PAI), a ten-item scale designed to assess symptom endorsement associated with performance validity test failure in neuropsychological samples. The study utilized a mixed neuropsychological sample of consecutively referred patients at a large academic medical center in the Midwest. Participants and Methods:Participants were 332 patients who completed embedded and free-standing performance validity tests (PVTs) and the PAI. Pass and fail groups were created based on PVT performance to evaluate classification accuracy of the CBS. Results: The results were generally consistent with the initial study for overall classification accuracy, sensitivity, and cut-off score. Consistent with the validation study, CBS had better classification accuracy than the original PAI validity scales and a comparable effect size to that obtained in the original validation publication; however, the Somatic Complaints scale (SOM) and the Conversion subscale (SOM-C) also demonstrated good classification accuracy. The CBS had incremental predictive ability compared to existing PAI scales. Conclusions: The results supported the CBS, but further research is needed on specific populations. Findings from this present study also suggest the relationship between conversion tendencies and PVT failure may be stronger in some geographic locations or population types (forensic versus clinical patients).

Aggressive Personality and Aggressive Incidents: A Pilot Investigation of the Personality Assessment Inventory within Forensic Psychiatry

ABSTRACT Few studies to date have examined the utility of the Personality Assessment Inventory (PAI) in predicting aggressive behaviour among those deemed ‘not criminally responsible on account of a mental disorder.’ In this pilot study, 25 forensic psychiatric patients with a history of violence and diagnosed with psychosis and 20 healthy controls completed the PAI aggression (AGG) scale – composed of subscales attitude (A), verbal (V), and physical (P) – and positive impression management scale. Data regarding aggressive incidents during the 3 months post-testing were obtained through clinician ratings on the Aggressive Incidents Scale. Patients were differentiated from controls by the AGG-V and AGG-P subscales. AGG-A and AGG-V subscales were positively associated with severe aggressive incidents in hospital. These findings highlight the relevance of PAI scales for clinicians to evaluate greatest potential for aggressive behaviour on forensic psychiatric units and the need to further investigate its applicability for understanding violence risk.

A-211 Examination of the Personality Assessment Inventory and Performance Validity Tests: Correlation between Response Styles, Performance Effort, and Somatic Complaint

Abstract Objective Correlation between the performance validity measures from the Advanced Clinical Solution (ACS) package and select scales from the Personality Assessment Inventory (PAI) were examined to investigate relationships between performance effort and response styles involving negative impression (NIM), inconsistency (ICN), infrequency (INF), and somatic compliant (SOM) scales. Theoretical differences between symptom validity based on self-report questionnaires and credibility of performance on a performance validity tests (PVTs) were considered. Method Archival data from clinical neuropsychological evaluations between the years 2015–2018 were reviewed, and 120 consecutive adult cases involving 68 males and 52 females between the ages of 19–69 were collected. Examined measures included: ACS—Word Choice Test (WCT), Reliable Digit Span, Visual Reproduction II Recognition, Logical Memory II Recognition, and the PAI. Spearman’s rank-order correlation and point-biserial correlation analyses were conducted to examine the relationship between variables. Results WCT had significant negative correlations with the NIM scale (rs(118) = −.203, p = .013). Modest correlations were found between SOM and WCT when examining PVT raw score (rs (118) = −.192, p = .018) and base rate performance (rs(118) = −.222, p = .007). Point-biserial serial analysis found a weak negative correlation between performance credibility and the SOM scale, which was statistically significant (rpb = −.221, n = 120, p = .008). Conclusions NIM T-scores appear to be correlated with lower performance on the WCT, suggesting that an exaggerated or distorted impression of the self is associated with higher risk of poorer performance the stand-alone PVT. Correlation between embedded PVTs and PAI scales were inconsistent.

The Personality Assessment Inventory (PAI): Treatment Scales and Interpersonal Characteristics in a Sample of Men Charged with or Convicted of a Sexual Offense.

An individual's interpersonal features are pertinent to treatment within clinical populations. The Personality Assessment Inventory (PAI) contains two scales that assess the interpersonal features of warmth (WRM) and dominance (DOM), as well as two additional measures to assess to treatment prediction, process, and rejection (RXR; TPI). The current study examined associations between these PAI scales in a sample of 92 men who underwent comprehensive evaluations of sexual behavior after being charged with or convicted of a sexual offense. Analyses indicated that RXR was positively associated with WRM and DOM, TPI was negatively associated with WRM, and the two interpersonal scales of WRM and DOM were positively correlated with each other. A significant inverse relationship was found between the two treatment scales RXR and TPI indicating that motivation for treatment may have a limited relationship with the treatment process. WRM significantly predicted scores on the TPI, and both WRM and DOM predicted individual scores on RXR. Higher scores on positive impression management (PIM) were predictive of lower TPI and higher RXR, as individuals with higher stakes cases may score higher on PIM and underreport obstacles within treatment or be unwilling to accept the need for treatment. Overall, findings suggest that interpersonal characteristics identified by the PAI scales may be advantageous in approaching treatment within this population.

Personality psychopathology: Longitudinal prediction of change in body mass index and weight post-bariatric surgery.

Bariatric surgery is an effective treatment for obesity, which has been increasing worldwide. However, bariatric surgery causes dramatic physical changes that can cause significant stress. Prior research has found that psychological variables such as personality traits and levels of psychopathology can influence success after bariatric surgery (in terms of body mass index [BMI] reduction and weight loss). However, most prior studies have been limited by small sample sizes, inconsistent follow up, and categorical assessment of psychopathology. The present study examines the predictive utility of the Personality Assessment Inventory (PAI) scales for three bariatric surgery outcomes (BMI reduction, weight loss, and percent excess weight loss [%EWL]) across 10 follow-up points 5 years after surgery. It also examines the largest sample of bariatric surgery-completing patients (N = 2,267) on the PAI to date. Latent growth modeling was used to examine change in the outcome variables. Results indicate that personality and psychopathology variables predicted less BMI reduction, weight loss, and %EWL 5 years after surgery and also affected the trajectories of change in the outcome variables across time. The PAI scales predicted more variance in the 5-year BMI outcomes than did age and gender. The most robust effects were for scales assessing phobias, traumatic stress, identity problems, and negative relationships. The PAI may be useful to clinical health psychologists who conduct recommended psychological evaluations with potential bariatric surgery candidates. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Stratified performance on the Test of Memory Malingering (TOMM) is associated with differential responding on the Personality Assessment Inventory (PAI)

ABSTRACTIntroduction: This study evaluated symptom endorsement patterns in participants at various stratified performance levels on the Test of Memory Malingering (TOMM). It was hypothesized that the lowest stratum (chance performance and below) would have the most pathological (i.e., elevated item endorsement) responding on the Personality Assessment Inventory (PAI) validity and clinical scales. This study was primarily a replication of previous work with emphasis on the PAI scales and consideration of varying degrees of performance on TOMM Trial 2.Methods: Participants were 760 (54% female, 85.4% Caucasian, mean age = 42.01 (SD = 15.89), mean education = 13.55 (SD = 2.35)) consecutively referred neuropsychological outpatients who completed the TOMM and PAI. Participants were placed in one of 5 stratified TOMM Trial 2 performance level groups (High Pass, Low Pass, High Fail, Low Fail, and Chance). No significant differences were found between the demographic variables except for referral source, which was overrepresented in the Chance group relative to the other groups.Results: Due to the highly skewed nature of TOMM Trial 2, Spearman rank order correlations were calculated for the 5 stratified levels of TOMM performance and all the main PAI scales. The NIM, SOM, DEP, ANX, SCZ and SUI scales had significant correlations, so a series of One-way ANOVAs were calculated to examine these scales at different TOMM stratified performance levels. Results indicated that the Chance group had the highest level of responding on all scales, with NIM, SOM, DEP, SCZ and SUI having mean elevations above the clinical cutoff (T = 70).Conclusions: Results were consistent with previous pass-fail PVT research, but extended earlier research to provide evidence that Chance performance group had more pathological PAI responding. The results provide preliminary evidence to support the notion that patients who fail PVTs at different levels do not have the same characteristics.

Forensic Assessment With the PAI in Correctional Samples: Implications for RNR

The present investigation examined Risk-Need-Responsivity (RNR) correlates of Personality Assessment Inventory (PAI) scores in a sample ( N = 377) of offenders with diverse criminal histories. It was hypothesized that PAI scales with content reflective of criminogenic needs would be associated with recidivism while those indicative of major mental illness and behavioral disruption would be positively linked to responsivity variables. Several PAI scales predicted general and violent recidivism, particularly those reflective of criminogenic need. More serious profile patterns were associated with younger age, less education, lower cognitive ability, and sexual offense treatment attrition, per the responsivity principle. Finally, an exploratory factor analysis identified four PAI factors: Major Mental Illness, Extraversion, Paranoia, and Antisociality. Antisociality scores were the most predictive of general and violent recidivism. Antisociality and Major Mental Illness scores also predicted treatment attrition. Study findings suggest that the PAI can be a useful adjunct to standardized risk and need measures for RNR-informed assessment.

Personality profiles of patients with alcohol use disorder and opioid use disorder in an inpatient treatment setting

The present study aimed to compare personality profiles of alcohol use disorder and opioid use disorder patients in an inpatient chemical dependency rehabilitation unit using a multidimensional personality inventory, the Personality Assessment Inventory (PAI). Ninety-six patients meeting DSM-IV-TR diagnoses for alcohol use or opioid use disorders completed the PAI at admission. Results revealed largely normative patterns across most PAI scales, though alcohol use disorder patients showed clinically elevated scores on Alcohol Problems and Drug Problems, and opioid use disorder patients showed clinical elevations on Antisocial Features, Borderline Features, and Drug Problems. Opioid use disorder patients showed, on average, significantly higher scores than alcohol use disorder patients on Borderline Features, Antisocial Features, Drug Problems, and Suicidal Ideation. Alcohol use disorder patients showed significantly higher scores than opioid use disorder patients only on Alcohol Problems. Discriminant function analysis (DFA) showed discriminability between patient groups using the PAI clinical scales and treatment scales, highlighting higher levels of disturbed functioning among opioid use disorder patients with respect to clinical syndromes, especially borderline features, antisocial features, suicidal ideation, and anxiety. These findings underscore the need to tailor treatment recommendations to distinctive patterns of personality pathology, especially among opioid use disorder patients.

Psychometric properties of the Italian version of the Personality Assessment Inventory (PAI).

The Personality Assessment Inventory (PAI) has been translated into different languages (e.g., Spanish, German, and Greek) and several authors investigated psychometric properties, internal structure, and the convergent validity of translated versions of the PAI. Recently, an Italian version of the test has been published, but its psychometric properties has never been explored. The aims of the present study were: (a) to examine the hypothesized subscale structure of scales that have subscales, (b) to evaluate the internal structure of the 22 PAI full scales, and (c) to report on the convergent validity of the PAI scales with the Millon Clinical Multiaxial Inventory-III (MCMI-III) scales. The sample consisted of 1,538 participants recruited from all over Italy. Our findings provided support to the cross-cultural applicability of the PAI and contributed to enhance confidence in the validity and utility of the PAI. (PsycINFO Database Record

Cross-validation of PAI scales for the detection of suspected ADHD in adults.

The purpose of this study was to cross-validate scales and subscales of the Personality Assessment Inventory (PAI) identified in previously published research against criterion variables for the identification of Attention Deficit/Hyperactivity Disorder (ADHD) in adults. Performance-based indicators of attention deficits from the Wechsler Adult Intelligence Scale-Fourth Edition were used as criterion variables. In a hierarchical logistic regression analysis, the addition of the PAI scales to the criterion variables did significantly improve the fit of the model, with an overall classification accuracy of 75%. Limitations of this study and implications for future research are discussed.

Association of depression, anxiety and post-traumatic stress disorder with migraine: Data from Kosovo

IntroductionMigraine is ranked as the seventh leading cause of disability worldwide, and it is characterized by a manifestation of combined neurological, gastrointestinal, and autonomic symptoms linked with different provoking factors. Aim of the studyThis study investigates the association between migraine and PTSD, depression and anxiety in the Kosovo population during the post-war period. Material and methods273 war survivors with headache were enrolled in the study and were divided into two groups: 153 individuals with confirmed migraine (the study group) and 120 individuals with non-migraine headaches (control group). All individuals were evaluated using the ICHD-II 2004 diagnostic criteria for migraine, as well as the mini-test for PTSD, MMPI (Minnesota Multiphasic Personality Inventory) for psychological evaluation, PAI (Personality Assessment Inventory) and Hamilton Scale for Depression. ResultsAmong migraine patients, depressive disorders were present in 27.5% of patients, anxiety was found in 60.8%, and PTSD was present in 39.2%. While the prominence of depression was not different between groups, anxiety was significantly more common (p<0.05) in women from the control group. PTSD was significantly more common (p<0.001) in migraine patients overall, whereas the difference in PTSD prevalence between women from the migraine and control groups came close to significance (p=0.05). Females in the migraine group had higher incidences of aura (50% vs. 25.5%), whereas the incidence of aura in males in each group was approximately equal (9.8% vs. 7.84%). ConclusionBased on our data, we can confirm an association between PTSD and migraine in a sample of patients from Kosovo.

Utility of the Personality Assessment Inventory in detecting feigned Attention-Deficit/Hyperactivity Disorder (ADHD): The Feigned Adult ADHD index

The high potential for secondary gain among college students presenting for Attention-Deficit/Hyperactivity Disorder (ADHD) evaluations highlights the need for psychometrically sound embedded validity indicators. The purpose of this study was to develop new validity indicators specific to feigned ADHD for the Personality Assessment Inventory (PAI) and compare them to preexisting imbedded PAI validity measures. PAI scales that were theoretically related to feigned ADHD were evaluated. A binomial (ADHD simulators, n = 138, and genuine ADHD, n = 142) logistic regression was conducted with selected PAI scales and subscales. Classification rates were compared between the new and existing validity scales. A similar approach was used for item-level data in a second study in a subgroup of the original sample. The derived PAI scale-based logistic regression had a sensitivity of 54% and specificity of 92%. This algorithm accurately identified 97% of healthy controls as not feigning ADHD and correctly identified 98% of a no diagnosis group and 75% of a mood/anxiety disorders group. Classification accuracy of the new index was superior to the majority of existing PAI validity scales across groups. An item-level PAI algorithm had a sensitivity of 85% and specificity of 97% for identifying feigned ADHD. New validity measures were compared to existing PAI validity indicators and performed better than many of them in this study. The algorithms developed in this study of ADHD simulators and genuine ADHD cases have adequate sensitivity and good specificity and appear to function differently than other PAI symptom validity scales.

The empirically derived Violence and Aggression Risk Index from the Personality Assessment Inventory: Development, validation, and application in general psychiatric settings.

The current study developed a new index of violence risk from scales within the Personality Assessment Inventory (PAI). Clinical patients from inpatient and outpatient settings completed the PAI along with reports of violence history and arrest record. A forward-selection hierarchical logistic regression was employed (N = 388) to identify the PAI scales (AGG-P, AGG-A, NON, PAR-H, and ANT-A) that could effectively distinguish patients with and without a history of violence. These indicators were then aggregated into a single index, labeled the Violence and Aggression Risk Index (VARI). The VARI modestly incremented other PAI subscales and indices in an independent clinical sample (N = 387). The authors discuss how the VARI can be incorporated with the other PAI scales to assess violence risk.

Testing the predictive validity of the Personality Assessment Inventory (PAI) in relation to inmate misconduct and violence.

The Personality Assessment Inventory (PAI) has been widely employed in correctional settings as a screening tool to assess inmates' risk for committing various types of institutional misconduct. Evaluations have generally found the PAI scales Antisocial Features (ANT), Aggression (AGG), and the Violence Potential Index (VPI) to be modestly related to institutional misbehavior, thus supporting its construct validity. The current study provides the most comprehensive examination of the predictive and incremental validity of the PAI and its subscales among a large sample of imprisoned offenders to date. In particular, the size of the sample (n = 15,546) and follow-up period (mean time at risk of 2.2 years) allowed for the disaggregation of institutional misconduct by levels of seriousness and separate examinations by conviction offense and criminal history variables. The 3 scales most strongly related to general rule infractions were ANT, AGG, and the VPI. After controlling for age at intake, violent conviction history, prior violent arrests, and time at risk, the PAI scales were shown to add incremental validity to the classification of 4 types of disciplinary infractions ranging from 2 to 4 percentage points. The study also explored the relationship of the PAI's response bias scales to institutional misconduct. (PsycINFO Database Record

Gender-responsiveness in corrections: Estimating female inmate misconduct risk using the Personality Assessment Inventory (PAI).

Proper inmate assessment is critical to correctional management and institutional security. While many instruments have been developed to assist with this process, most of these tools have not been validated using samples of female inmates although distinct gender differences have been identified in the inmate population in terms of adaptation and misconduct. The Personality Assessment Inventory (PAI) is a multiscale measure of psychopathology that is being increasingly utilized in the correctional setting to assist with the inmate classification process. The current study contributes to the dearth of literature surrounding gender-responsive inmate classification by utilizing a sample of 2,000 female inmates to examine the incremental and predictive validity of the PAI in association with general and assaultive disciplinary infractions. Findings from this study reveal that the PAI scales presenting the strongest relationship to general and assaultive disciplinary infractions among this female sample included Aggression (AGG), Antisocial Features (ANT), Paranoia (PAR), and the Violence Potential Index (VPI). Moreover, findings derived from this study suggest that certain PAI measures, specifically ARD-T, DRU, and more general substance abuse and mental health indicators may be useful in gender-responsive assessments during the female inmate classification process.

Empirical Identification of Psychological Symptom Subgroups of Sex Addicts: An Application of Latent Profile Analysis

The current study utilized latent profile analysis (LPA) to uncover discrete classes of sex addicts based upon psychological symptom profiles. An LPA was conducted with sex addicts in residential treatment (N = 222, 95.5% male, 92.3% Caucasian), using scores from the Personality Assessment Inventory (PAI) as indicators of class membership. The LPA yielded evidence for 5 latent classes in this sample of sex addicts. Based upon class average PAI scale profiles, the following labels for the classes were suggested: Class 1—No Comorbid Psychopathology (22.8% of the sample), Class 2—Dysfunctional Negative Emotions (14.9%), Class 3—Mild Depression and Substance-Related Problems (38.1%), Class 4—Clinical Depression and Anxiety (18.8%), and Class 5—Severe Psychopathology (5.6%). It is noteworthy that Classes 1 and 2 (37.7% of the sample), had PAI profiles that were not clinically significant, and thus are unlikely to have other disorders, whereas the mean PAI scores for Classes 4 and 5 indicate that members of these classes are highly likely to present with other diagnosable psychological disorders, especially mood and anxiety disorders. Class 3 is somewhere in between, with likely clinically significant issues with depression, anxiety, and substance-related problems, but which may be in the subthreshold range for a comorbid diagnosis. The results highlight the importance of broad-band psychological assessment to facilitate treatment planning for sex addicts.

Personality characteristics and experiential avoidance in Trichotillomania: Results from an age and gender matched sample

Despite its prevalence and a growing body of research, significant gaps remain in the knowledge of trichotillomania (TTM). The current study sought to address this issue by examining personality characteristics, impulsivity, and experiential avoidance of those with TTM compared to an age and gender matched sample. 56 Female participants (28 with TTM and 28 non-clinical age-matched controls) completed the Personality Assessment Inventory (PAI), Barratt's Impulsivity Scale (BIS), and the Acceptance and Action Questionnaire (AAQ). Paired-sample t-tests compared each of the 28 individuals who met criteria for TTM to an age and gender matched individual who did not meet criteria for TTM or any Axis I condition. Significant differences were found between many of the PAI scales and subscales, impulsivity, and experiential avoidance. The TTM group displayed higher levels of pathology than the control group. The findings provide evidence that individuals with TTM demonstrate differing levels of personality characteristics compared to individuals without TTM and that treatment may benefit from acknowledging and targeting these areas.