Personality Assessment Inventory™ (PAI®)
Leslie C. Morey, PhD
With its revised Professional Manual, Profile Form Adults–Revised, and Critical Items Form–Revised, the PAI continues to raise the standard for the assessment of adult psychopathology. This objective inventory of adult personality assesses psychopathological syndromes and provides information relevant for clinical diagnosis, treatment planning, and screening for psychopathology. Since its introduction, the PAI has been heralded as one of the most important innovations in the field of clinical assessment.
PAI Scales and Subscales
The 344 PAI items constitute 22 nonoverlapping scales covering the constructs most relevant to a broad-based assessment of mental disorders: four validity scales, 11 clinical scales, five treatment scales, and two interpersonal scales. To facilitate interpretation and to cover the full range of complex clinical constructs, 10 scales contain conceptually derived subscales.
The PAI Clinical scales were developed to provide information about critical diagnostic features of 11 important clinical constructs. These 11 scales may be divided into three broad classes of disorders: those within the neurotic spectrum, those within the psychotic spectrum, and those associated with behavior disorder or impulse control problems.
The Treatment scales were developed to provide indicators of potential complications in treatment that would not necessarily be apparent from diagnostic information. These five scales include two indicators of potential for harm to self or others, two measures of the respondent's environmental circumstances, and one indicator of the respondent's motivation for treatment.
The Interpersonal scales were developed to provide an assessment of the respondent's interpersonal style along two dimensions: a warmly affiliative versus a cold rejecting style, and a dominating/controlling versus a meekly submissive style. These axes provide a useful way of conceptualizing many different mental disorders: persons at the extremes of these dimensions may present with a variety of disorders. A number of studies provide evidence that diagnostic groups differ on these dimensions.
The PAI includes a Borderline Features scale and an Antisocial Features scale. Both of these scales specifically assess character pathology. The Borderline Features scale is the only PAI scale that has four subscales, reflecting the factorial complexity of the construct. The Antisocial Features scale includes a total of three facets: one assessing antisocial behaviors and the other two assessing antisocial traits
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Scale (Acronym/No. of items)
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| Validity scales |
Description |
| Inconsistency (ICN/10 item pairs) |
Indicates if client is answering consistently throughout inventory. Each pair consists of highly correlated (i.e., positively, negatively) items. |
| Infrequency (INF/8) |
Indicates if client is responding carelessly, randomly, or idiosyncratically. Items are neutral with respect to psychopathology and have either extremely high or extremely low endorsement rates. |
| Negative Impression (NIM/9) |
Suggests an exaggerated, unfavorable impression or malingering.
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Positive Impression (PIM/9)
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Suggests the presentation of a very favorable impression or reluctance to admit minor flaws.
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| Clinical scales |
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| Somatic Complaints (SOM/24) |
Focuses on preoccupation with health matters and somatic complaints typically associated with somatization or conversion disorders. |
| Anxiety (ANX/24) |
Focuses on phenomenology and observable signs of anxiety with an emphasis on assessment across different response modalities. |
| Anxiety-Related Disorders (ARD/24) |
Focuses on symptoms and behaviors related to specific anxiety disorders, particularly phobias, traumatic stress, and obsessive-compulsive symptoms. |
| Depression (DEP/24) |
Focuses on symptoms and phenomenology of depressive disorders. |
| Mania (MAN/24) |
Focuses on symptoms and phenomenology of depressive disorders. |
| Paranoia (PAR/24) |
Focuses on symptoms of paranoid disorders and more enduring characteristics of paranoid personality. |
| Schizophrenia (SCZ/24) |
Focuses on symptoms relevant to the broad spectrum of schizophrenic disorders. |
| Borderline Features (BOR/24) |
Focuses on attributes indicative of a borderline level of personality functioning, including unstable and fluctuating interpersonal relations, impulsivity, affective lability and instability, and uncontrolled anger. |
| Antisocial Features (ANT/24) |
Focuses on history of illegal acts and authority problems, egocentrism, lack of empathy and loyalty, instability, and excitement-seeking. |
| Alcohol Problems (ALC/12) |
Focuses on problematic consequences of alcohol use and features of alcohol dependence.
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| Drug Problems (DRG/12) |
Focuses on problematic consequences of drug use (i.e., prescription, illicit) and features of drug dependence.
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Treatment Consideration scales
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| Aggression (AGG/18) |
Focuses on characteristics and attitudes related to anger, assertiveness, hostility, and aggression. |
| Suicidal Ideation (SUI/12) |
Focuses on suicidal ideation, ranging from hopelessness to thoughts and plans for the suicidal act. |
| Stress (STR/8) |
Focuses on the impact of recent stressors on major life areas. |
| Nonsupport (NON/8) |
Focuses on a lack of perceived social support, considering both the level and quality of available support. |
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Treatment Rejection (RXR/8)
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Focuses on attributes and attitudes indicating a lack of interest and motivation in making personal changes of a psychological or emotional nature. |
| Interpersonal scales |
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| Dominance (DOM/12) |
Assesses the extent to which a person is controlling and independent in personal relationships. A bipolar dimension, with a dominant style at the high end and a submissive style at the low end. |
| Warmth (WRM/12) |
Assesses the extent to which a person is interested in supportive and empathic personal relationships.
A bipolar dimension, with a warm, outgoing style at the high end and a cold, rejecting style at the low end. |
No Scoring Keys Needed
Clients with 4th-grade reading skills can usually complete the PAI in less than 1 hour, rating each of the 344 items on a 4-point scale ranging from False, not at all true, to Very true. Responses are entered on a two-part carbonless Answer Sheet. The bottom page of the Answer Sheet provides scores for all 344 items. Scales and subscales can be hand scored in only 15-20 minutes.
For situations in which no desk or tabletop is available, the handy PAI Administration Folio holds both the Item Booklet and Answer Sheet and provides a hard surface so your clients can easily complete the inventory.
The PAI® Software Portfolio (PAI®-SP) provides unlimited comprehensive, useful and accurate 10- to 15-page PAI Clinical Interpretive Reports or 2- to 4-page PAS® Score Reports.
Interpreting PAI Test Results
To provide interpretation relative to the standardization sample of 1,000 community-dwelling adults, PAI scale and subscale raw scores are translated to T scores. Transformed T scores have a mean of 50 and a standard deviation of 10, so that T-score values greater than 50 are above the mean in comparison to scores of individuals in the standardization sample. Therefore, T scores greater than or equal to 70 (2 standard deviations above the mean) will quickly alert you to a pronounced deviation from typical responses of adults in the normative sample.
The Profile Form Adults–Revised allows you to rapidly translate raw scores to T scores and plot the pattern of test results, and it also contains a blue clinical skyline demarcating the distribution of scores for a large sample of clinical cases. This feature facilitates comparison of an individual's scores with those in the clinical sample.
Critical Items
The Critical Items Form–Revised lists 27 items (distributed across nine content areas) that suggest behavior or psychopathology that may demand immediate attention. They are identified as critical based on two criteria: indications of a potential crisis situation and a very low endorsement rate in normal individuals.
Reliability/Validity
Reliability and validity are based on data from a U.S. Census-matched normative sample of 1,000 community-dwelling adults (matched on the basis of gender, race, and age), a sample of 1,265 patients from 69 clinical sites, and a college sample of 1,051 students.
Because the PAI was normed on adults in a variety of clinical and community settings, profiles can be compared with both normal and clinical populations. Combined-gender normative data are provided. Reliability studies indicate that the PAI has a high degree of internal consistency across samples—results are stable over periods of 2-4 weeks (median alpha and test-retest correlations exceed .80 for the 22 scales). Validity studies demonstrate convergent and discriminant validity with more than 50 other measures of psychopathology.
New Features
- This edition of the Professional Manual addresses many areas of additional study and research, includes an expanded discussion of administration considerations and a variety of strategies for the interpretation of clinical data.
- The revised Professional Manual now includes both the original reliability and validation studies of the instrument and pertinent reliability/validity data from important subsequent research studies of the original PAI scales as well as the supplemental scales and indexes.
- The Profile Form Adults has been revised to provide a simpler and easier method of translating PAI raw scores to T scores for all scales, subscales, supplemental scales, and indexes, as well as for plotting the pattern of test results.
- The Critical Items Form–Revised has the potential to quickly alert the clinician to possible crisis situations that might require immediate attention. Consisting of 27 items, this revised form eliminates several overlapping items and includes six new items that are particularly valuable for assisting with PAI profile interpretation. The original Critical Item content areas have been retained, and two new content areas (Response Set and Idiosyncratic Context) have been added.
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