Personality Assessment Inventory (PAI) Profiles of Male Veterans With Combat-Related Posttraumatic Stress Disorder

The Personality Assessment Inventory (PAI; L. C. Morey, 1991) is a promising tool for the assessment of Posttraumatic Stress Disorder (PTSD), but few studies have examined the PAI profiles of individuals with the diagnosis. In this study, the PAI was administered to 176 combat veterans with PTSD. Results showed significant elevations on scales measuring depression, somatic complaints, anxiety, anxiety-related disorders, schizophrenia, and negative impression management. The Traumatic Stress subscale was the highest point in the mean score profile and was moderately correlated with several established measures of PTSD. Veterans with and without comorbid major depression differed on PAI scales assessing depression, anxiety, and warmth. Analysis of two-point codetypes for the PAI and the MMPI-2 revealed substantial heterogeneity in symptom endorsement on both instruments, suggesting that there may be no clear PTSD profile on either instrument. Results provide a reference point for future work with the PAI in PTSD samples.     

Use of the Personality Assessment Inventory in Assessment of Posttraumatic Stress Disorder in Women

This study investigated the utility of the Personality Assessment Inventory (PAI) for the assessment of posttraumatic stress disorder (PTSD). Participants were 55 community-residing adult women who were administered a comprehensive battery that included the PAI and the Clinician-Administered PTSD Scale (CAPS). Participants were classified as either PTSD or non-PTSD based on the CAPS, and PAI profiles were compared between the two groups. Significant group differences were found for seven PAI clinical scales (Anxiety, Depression, Anxiety-Related Disorders, Somatic Complaints, Paranoia, Borderline Features, and Schizophrenia), one validity scale (Negative Impression), and two treatment scales (Nonsupport and Treatment Rejection). When all PAI scales and component subscales are considered, the largest group differences were found for the physiological subscale of the Depression scale (DEP-P) and the Traumatic Stress subscale of the Anxiety-Related Disorders scale (ARD-T). ARD-T and DEP-P also demonstrated excellent diagnostic utility. Finally, correlations between PAI scales and four CAPS symptom clusters provided additional validity evidence, in particular supporting a distinction between effortful avoidance and numbing. Taken together, these results support the use of the PAI in the assessment of PTSD.This study was the basis of a Masters thesis for Meghan McDevitt-Murphy. Portions of this study were presented at the annual meeting of the Association for Advancement of Behavior Therapy, November 2000.     

A General Factor of Personality in the Millon Clinical Multiaxial Inventory-III, the Dimensional Assessment of Personality Pathology, and the Personality Assessment Inventory

A General Factor of Personality (GFP) occupies the apex of the hierarchy in three prominent personality disorder inventories. On the Millon Clinical Multiaxial Inventory-III, a GFP accounted for 41% of the variance in two second-order factors, 31% of the variance in five first-order factors, and 26% of the variance in all 24 scales. On the Dimensional Assessment of Personality Pathology, a GFP accounted for 61% of the variance in six first-order factors and 36% of the variance in all 18 scales. In a cross-validation study of the Personality Assessment Inventory, a GFP accounted for 65% of the variance in two second-order factors, 47% of the variance in five first-order factors, and 27% of the variance in all 18 scales.     

A Multitrait-multimethod examination of Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI)

Recently, certain Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) scales have seen increasing usage for the measurement of DSM-III personality disorders. The current study sought to identify the convergent and discriminant validity of these two sets of scales for this purpose. In general, the results indicated significant convergence across the two instruments. However, better convergent validity was found for scales representing those DSM-III disorders which are most consistent with the typology upon which the MCMI was based. In particular, convergent and discriminant validity results were poorest for Compulsive, Antisocial, and Passive-Aggressive personality scales.     

Construct interpretation of Minnesota Multiphasic Personality Inventory (MMPI) clinical scales: An orthogonal transformation

The implications for personality test construction of the revolution in testing caused by construct validity considerations are outlined, with particular relevance to the assessment of psychopathology. These include (a) substantive definition of constructs; (b) concern for internal consistency reliability as well as generalizability; (c) evaluation of structural relationships among items and scales; (d) suppression of response biases; (e) emphasis on minimum redundancy among scales; (f) evaluation of convergent and discriminant validity of scales and profiles; and (g) evaluation of criterion validity for configurations of scales and profiles, as well as single scales. Benefits are seen as accruing to an increased understanding of psychopathology and higher levels of validity. Prior, and subsequent, to the forthcoming revision of the Minnesota Multiphasic Personality Inventory (MMPI), one approach to realizing some of the aims of construct measurement with an empirically based test is through an orthogonal transformation of the scales. Preliminary results for the extant MMPI clinical scales are reported, yielding evidence of (a) scale independence while retaining high correlations with uncorrected scales, (b) an appropriate pattern of correlations with a separate set of new scales of psychopathology, (c) a possible basis for new item analyses, and (d) freedom from correlations with a putative measure of response bias. Implications of the orthogonal transformation for profile interpretation are discussed.Portions of this paper were presnted at an invited address, 18th Annual Symposium on Recent Developments in the Use of the MMPI, Minneapolis, April 9, 1983. This paper was written while Douglas N. Jackson was distinguished visiting professor at the College of Education, The University of Iowa. This research has been supported by Research Grant 895-84/86 from the Ontario Mental Health Foundation, Research Grant 411-83-0014 from the Social Sciences and Humanities Research Council of Canada, and the Alberta Hospital Edmonton.     

Posttraumatic Stress Disorder and Associated Functional Impairments During Pregnancy: Some Consequences of Violence Against Women

Despite the high prevalence of violence in the lives of women of reproductive age, and the adverse consequences posed to pregnant women suffering from PTSD, few studies have examined violence-related trauma and PTSD among pregnant women. A structured research interview was administered to a convenience sample of 85 prenatal care women to collect information regarding their experiences of violence victimization, PTSD symptoms related to violence-related traumatic events, and whether these symptoms impaired various aspects of the women's daily functioning. Results indicated that 69% of the women experienced a violent traumatic event, with the majority of events occurring before the current pregnancy and being perpetrated by the women's intimate partners. The traumatized women evidenced high levels of PTSD symptoms during pregnancy, with 58% of the women meeting criteria for a PTSD diagnosis. Moreover, many of the women with PTSD symptoms reported that the symptoms adversely affected aspects of their daily functioning.     

The Assessment of Post‐traumatic Stress Disorder for Workers' Compensation in Emergency Service Personnel

There is considerable debate concerning the diagnosis of post‐traumatic stress disorder (PTSD) in compensation claims. This study reviewed the quality of the assessment reports prepared by clinicians who evaluated 31 emergency service workers making PTSD‐related compensation claims. Assessments were conducted by 4‐year trained psychologists (39%), psychologists holding a masters degree (36%), and psychiatrists (19%). The assessment reports were evaluated relative to the diagnostic criteria for PTSD in the Diagnostic and Statistical Manual of Mental Disorders 4th edition (2000). In the majority of cases (81%), the assessor determined that the emergency service worker had PTSD, but only one report met the minimum standard for that diagnosis. In the majority (65%) of cases the clinician failed to address the possibility of malingering. These data suggest that clinical assessment reports for PTSD frequently fail to meet minimum assessment standards.     

Clinical Validation of the Swedish Version of the Quality of Life Inventory in Crime Victims with Posttraumatic Stress Disorder and a Nonclinical Sample

The Swedish version of the Quality of Life Inventory (QOLI) was cross-culturally validated with a crime victim sample (N = 53) with posttraumatic stress disorder (PTSD) and a nonclinical group (N = 100) with no lifetime and current psychiatric disorder from the general population in the Stockholm county of Sweden. The QOLI showed excellent internal consistencies in the clinical and the nonclinical sample. In addition, PTSD participants displayed a significantly lower self-perceived quality of life in 13 out of 16 domains of life than the nonclinical individuals. Furthermore, the QOLI was inversely correlated with interview and self-report measures of PTSD symptoms, depression, and anxiety. Overall, the results support the utility of the Swedish QOLI version as a potentially useful measure of self-perceived quality of life in Swedish clinical and nonclinical samples. The results are discussed in relation to the Swedish cross-cultural validation of the QOLI, methodological limitations and future directions.     

Minnesota Multiphasic Personality Inventory (MMPI)-derived psychopathology subtypes among former prisoners of war (POWs): Replication and extension

Psychopathology and symptom patterns identified among former prisoners of war (POWs) by Sutker, Winstead, Goist, Malow, and Allain (1986) were replicated in an independent sample of 51 former POWs with similar personal backgrounds and military experiences. Data collection instruments included the Minnesota Multiphasic Personality Inventory (MMPI), self-report measures of anxiety and depression, and a structured clinical interview including a POW Trauma Index. Two prototypic MMPI profile patterns were identified using modal profile analysis (Skinner & Lei, 1980). Both were highly similar in shape and elevation to those reported in the previous investigation. Multiprofile-multisample analysis produced prototypic profile patterns which were accurate representations of profiles identified in separate analyses of the derivation and replication samples (r's .96). Representing unique constellations of clinical features, profile subtypes were associated differentially with confinement stress severity, postservice adjustment, and nature and extent of stress-induced symptomatology.     

No evidence for a General Factor of Personality in the HEXACO Personality Inventory

There have been an increasing number of articles that have speculated on the existence of a General Factor of Personality (GFP) similar to ‘g’ in intelligence research. In this study, I provide evidence that this general factor may be an artifact of the personality instrument used. Specifically, in two samples I show that depending on the type of analysis used there is either no evidence for a GFP in the HEXACO Personality Inventory or the GFP is found to be uncorrelated to GFPs based on Big Five or FFM instruments.     

Psychological and sexual functioning among outpatient sexual offenders against children: A Minnesota Multiphasic Personality Inventory (MMPI) cluster analytic study

Multivariate clustering procedures were used to identify homogeneous subgroups of outpatient sex offenders against children (n=110)on the basis of the Minnesota Multiphasic Personality Inventory (MMPI). Results indicated a five-subgroup solution. Two within-normal-limits and two clinically elevated profile subgroups replicated subtypes found in previous cluster analytic studies of child sex offenders. The fifth subgroup appeared similar in MMPI profile pattern and elevation to a previously identified subtype of rapists. Discriminant analyses showed that subgroups differed along dimensions of cognitive disturbance and sexual functioning. Furthermore, levels of psychopathology corresponded with levels of sexual pathology. Results are discussed with reference to previous MMPI cluster analytic studies of sex offenders and theories of sexual aggression.Portions of this paper were presented at the meeting of the Midwestern Psychological Association, 1992, Chicago, Illinois.     

A Cross-Lagged Panel Approach to Understanding Social Support and Chronic Posttraumatic Stress Disorder Symptoms in Veterans: Assessment Modality Matters

Although there is a strong and consistent association between social support and posttraumatic stress disorder (PTSD), the directionality of this association has been debated, with some research indicating that social support protects against PTSD symptoms, whereas other research suggests that PTSD symptoms erode social support. The majority of studies in the literature have been cross-sectional, rendering directionality impossible to determine. Cross-lagged panel models overcome many previous limitations; however, findings from the few studies employing these designs have been mixed, possibly due to methodological differences including self-report versus clinician-administered assessment. The current study used a cross-lagged panel structural equation model to explore the relationship between social support and chronic PTSD symptoms over a 1-year period in a sample of 264 Iraq and Afghanistan veterans assessed several years after trauma exposure. Approximately a third of the sample met criteria for PTSD at the baseline assessment, with veterans’ trauma occurring an average of 6 years prior to baseline. Two separate models were run, with one using PTSD symptoms assessed via self-report and the other using clinician-assessed PTSD symptoms. Excellent model fit was found for both models. Results indicated that the relationship between social support and PTSD symptoms was affected by assessment modality. Whereas the self-report model indicated a bidirectional relationship between social support and PTSD symptoms over time, the clinician-assessed model indicated only that baseline PTSD symptoms predicted social support 1 year later. Results highlight that assessment modality is one factor that likely impacts disparate findings across previous studies. Theoretical and clinical implications of these findings are discussed, with suggestions for the growing body of literature utilizing these designs to dismantle this complex association.     

Recurrence of Posttraumatic Stress Disorder in Late Life: A Cognitive Aging Perspective

Clinical experience with older adults shows that many will experience PTSD symptoms in older adulthood because of trauma exposure early in life. Some of these patients struggled with PTSD in the distant past and remained symptomfree for decades only to have a recurrence of PTSD in late life. This paper outlines a cognitive aging explanation for the recurrence of PTSD. It is proposed that the age-related decreases in attention make the intrusion of trauma-related memories more likely. The increase in intrusive memories, combined with age-related decreases in working memory, explicit memory, and prospective memory, increases the subjective distress associated with the memories and results in a recurrence of PTSD.     

The Influence of Service Era: Comparing Personality Assessment Inventory (PAI) Scale Scores Within a Posttraumatic Stress Disorder Treatment Clinic (PCT)

Research is mixed on the role of service era in symptom endorsement among Veterans, with differences emerging depending on the instrument evaluated. This study compares Personality Assessment Inventory (PAI) scale scores of VA test-takers who served during the Vietnam, Desert Storm, or Post-9/11 service eras. The sample was collected at a VA Posttraumatic Stress Disorder Clinical Team. Associations between gender and combat exposure were also examined as covariates. Results suggest that Veterans’ self-report on the PAI is influenced by service era, even after accounting for gender and combat exposure during deployment. The largest differences were between Vietnam or Post-9/11 Veterans and those from the Gulf War era. Symptom differences typically varied across scales commonly associated with symptoms of trauma exposure/posttraumatic stress disorder. Implications for the clinical use of, and research with, the PAI and other broadband personality assessments within the VA healthcare system and trauma treatment settings are discussed.

     

Hierarchical structure of the Eysenck Personality Inventory in a large population sample: Goldberg’s trait-tier mapping procedure

The structure of the Eysenck Personality Inventory (EPI) is poorly understood, and applications have mostly been confined to the broad Neuroticism, Extraversion and Lie scales. Using a hierarchical factoring procedure, we mapped the sequential differentiation of EPI scales from broad, molar factors to more specific, molecular factors, in a UK population sample of over 6500 persons. Replicable facets at the lowest tier of Neuroticism included oversensitivity, mood lability, nervous tension and rumination. The lowest order set of replicable Extraversion facets consisted of social dynamism, sociotropy, haste, jocularity, communalism and impulsivity. The Lie scale consisted of an interpersonal virtue and a behavioral diligence facet. Users of the EPI may be well served in some circumstances by considering its broad Neuroticism, Extraversion and Lie scales as multifactorial, a feature that was explicitly incorporated into subsequent Eysenck inventories and is consistent with other hierarchical trait structures.     

Traditional Machismo and Caballerismo as Correlates of Posttraumatic Stress Disorder,Psychological Distress,and Relationship Satisfaction in Hispanic Veterans

An online survey was used to examine 45 Hispanic male veterans’ traditional machismo and caballerismo as correlates of posttraumatic stress disorder (PTSD), psychological distress, and relationship satisfaction. Higher traditional machismo was associated with higher PTSD severity and distress and lower relationship satisfaction. Psychometric properties of the Traditional Machismo and Caballerismo Scale were explored. Se utilizó una encuesta en línea para examinar el machismo y el caballerismo tradicionales de 45 veteranos hispanos varones, y su correlación con el trastorno de estrés post‐traumático (PTSD, por sus siglas en inglés), la angustia psicológica y la satisfacción en sus relaciones. Un mayor nivel de machismo tradicional se asoció con una mayor severidad del PTSD, así como con angustia y una menor satisfacción en las relaciones. Se exploraron las propiedades psicométricas de la Escala de Machismo y Caballerismo Tradicionales.     

Further evidence of the Narcissistic Personality Inventory’s validity problems: A meta-analytic investigation—Response to Miller, Maples, and Campbell (this issue)

Miller, Maples, and Campbell (this issue) present evidence that Rosenthal and Hooley’s (2010) concerns regarding the Narcissistic Personality Inventory’s (NPI) relation to psychological health may be unwarranted. To resolve this issue empirically, we conducted a meta-analysis (k = 54, N = 38,932). Meta-analytic results revealed that a subset of NPI items were indeed problematic; items that function poorly at differentiating narcissists from non-narcissists accounted entirely for the NPI’s connection to psychological health. These items were also strongly associated with self-esteem, but unrelated to aggression/anger. In contrast, the remaining NPI items were unrelated to psychological health, but associated with aggression/anger. We conclude that although the NPI measures narcissism, its poorest functioning items also link it to outcomes unrelated to narcissism.     

Attachment,Social Support,Resilience and Posttraumatic Stress Disorder Symptoms in Chinese Adults Living with HIV/AIDS

The present study aimed to examine the effects of attachment, social support and resilience on posttraumatic stress disorder (PTSD) symptoms in people living with HIV/AIDS. One hundred fifty-two HIV+ adults in China were investigated. The results suggested that attachment anxiety had a significant direct effect on PTSD symptoms and impacted PTSD symptoms indirectly though associations with social support and resilience. Attachment avoidance could also be considered a distal risk factor of PTSD symptoms via the mediation of social support and resilience. The findings highlight the importance of identifying trauma and PTSD symptoms in people affected by HIV/AIDS and suggest that people with attachment anxiety and low social support resources might be at high risk for PTSD.     

The General Factor of Personality in selection and assessment samples

In two large samples (N₁ = 44,971, N₂ = 7793) we tested the General Factor of Personality (GFP) in the Big Five, measured during selection and assessment. A GFP could clearly be identified in the data, explaining approximately 50% of the Big Five variance. We found indications for socially desirable response tendencies in a subgroup that was tested for selection purposes. Yet, this tendency did not affect the personality factor structure or the GFP characteristics. Moreover, in the selection sample, the GFP was moderately related to the Overall Assessment Rating. The findings confirm the GFP in an applied setting and support the idea that the GFP does not merely reflect methodological artifacts but is substantive.