Exploring the Assessment of the DSM–5 Alternative Model for Personality Disorders With the Personality Assessment Inventory

Section III of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013) contains an alternative model for the diagnosis of personality disorder involving the assessment of 25 traits and a global level of overall personality functioning. There is hope that this model will be increasingly used in clinical and research settings, and the ability to apply established instruments to assess these concepts could facilitate this process. This study sought to develop scoring algorithms for these alternative model concepts using scales from the Personality Assessment Inventory (PAI). A multiple regression strategy used to predict scores in 2 undergraduate samples on DSM–5 alternative model instruments: the Personality Inventory for the DSM–5 (PID–5) and the General Personality Pathology scale (GPP; Morey et al., 2011 Morey, L. C., Berghuis, H., Bender, D. S., Verheul, R., Krueger, R. F., &; Skodol, A. E. (2011). Toward a model for assessing level of personality functioning in DSM–5, Part II: Empirical articulation of a core dimension of personality pathology. Journal of Personality Assessment, 93, 347–353.[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]). These regression functions resulted in scores that demonstrated promising convergent and discriminant validity across the alternative model concepts, as well as a factor structure in a cross-validation sample that was congruent with the putative structure of the alternative model traits. Results were linked to the PAI community normative data to provide normative information regarding these alternative model concepts that can be used to identify elevated traits and personality functioning level scores.     

Validity Rates of the Personality Assessment Inventory and the Minnesota Multiphasic Personality Inventory–2 in a VA Medical Center Setting

This paper presents some notions regarding the all important question of projective stimulus ambiguity. It is suggested that in spite of the observation that TAT stimulus ambiguity has been the most studied, the problem of stimulus ambiguity must be considered a vital problem in relation to projective tests as a whole. Findings specific to an extended DAP (involving the inclusion of a self-portrait) are reported and the relevance of these findings to the problem of stimulus ambiguity is discussed.     

Contributions to the Dimensional Assessment of Personality Disorders Using Millon's Model and the Millon Clinical Multiaxial Inventory (MCMI–III)

To determine if psychopaths with low anxiety are afflicted with a variety of neurosis, groups of psychopaths reporting low and high anxiety were examined with a variety of projective techniques. The use of repressive defenses, accuracy of cognition, and existence of areas of intrapsychic conflict were compared. Variance analyses indicated that the low anxious psychopaths represented a mixture of psychopathic types with a wide range of use of repressive mechanisms. Analysis of uncommon themes on the TAT produced a list of apparent appropriateness for both types of subjects.     

The Factor Structure of the MMPI–2 Restructured Clinical (RC) Scales

Changes in Rorschach responses obtained in an unhypnotized state, a medium hypnotic trance and under deep hypnosis suggested that content can be interpreted as symbolizing important unconscious processes. As the depth of hypnosis increased, content tended to become sufficiently transparent to verify and extend the meaning of the original, unhypnotized response. Other alterations in the Rorschach related to the depth of the trance level were noted.     

Trait Variance and Response Style Variance in the Scales of the Personality Inventory for DSM–5 (PID–5)

Using self- and observer reports on the Personality Inventory for DSM–5 (PID–5) and the HEXACO Personality Inventory–Revised (HEXACO–PI–R), we identified for each inventory several trait dimensions (each defined by both self- and observer reports on the facet-level scales belonging to the same domain) and 2 source dimensions (each defined by self-reports or by observer reports, respectively, on all facet-level scales). Results (N = 217) showed that the source dimensions of the PID–5 were very large (much larger than those of the HEXACO–PI–R), and suggest that self-report (or observer report) response styles substantially inflate the intercorrelations and the alpha reliabilities of the PID–5 scales. We discuss the meaning and the implications of the large PID–5 source components, and we suggest some methods of controlling their influence.     

The Effect of Response Bias on the Personality Inventory for DSM–5 (PID–5)

Valid self-report assessment of psychopathology relies on accurate and credible responses to test questions. There are some individuals who, in certain assessment contexts, cannot or choose not to answer in a manner typically representative of their traits or symptoms. This is referred to, most broadly, as test response bias. In this investigation, we explore the effect of response bias on the Personality Inventory for DSM–5 (PID–5; Krueger, Derringer, Markon, Watson, & Skodol, 2013 Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2013). The Personality Inventory for DSM–5 (PID–5)–Adult (Full version). Washington, DC: American Psychiatric Association. [Google Scholar]), a self-report instrument designed to assess the pathological personality traits used to inform diagnosis of the personality disorders in Section III of DSM–5. A set of Minnesota Multiphasic Personality Inventory Restructured Form (MMPI–2–RF; Ben-Porath & Tellegen, 2008 Tellegen, A., & Ben-Porath, Y. S (2008). MMPI–2–RF technical manual. Minneapolis: University of Minnesota Press. [Google Scholar]/2011 Ben-Porath, Y. S., & Tellegen, A. (2011). MMPI–2–RF manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press. (Original work published 2008) [Google Scholar]) validity scales, which are used to assess and identify response bias, were employed to identify individuals who engaged in either noncredible overreporting (OR) or underreporting (UR), or who were deemed to be reporting or responding to the items in a “credible” manner—credible responding (CR). A total of 2,022 research participants (1,587 students, 435 psychiatric patients) completed the MMPI–2–RF and PID–5; following protocol screening, these participants were classified into OR, UR, or CR response groups based on MMPI–2–RF validity scale scores. Groups of students and patients in the OR group scored significantly higher on the PID–5 than those students and patients in the CR group, whereas those in the UR group scored significantly lower than those in the CR group. Although future research is needed to explore the effects of response bias on the PID–5, results from this investigation provide initial evidence suggesting that response bias influences scale elevations on this instrument.     

Hierarchical Structure and Cross-Cultural Measurement Invariance of the Norwegian Version of the Personality Inventory for DSM–5

The Personality Inventory for DSM–5 (PID–5) was created to aid a trait-based diagnostic system for personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013a American Psychiatric Association. (2013a). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.[Crossref] , [Google Scholar]). In this study, we aimed to evaluate the Norwegian version of the PID–5 by examining its score reliability, hierarchical structure, congruency with international findings, and cross-cultural measurement invariance with a matched U.S. sample. For this purpose, 503 university students (76% females) were administered the PID–5. The Norwegian PID–5 showed good score reliability and structural validity from 1 to 5 factors. The 5-factor structure was generally congruent with international findings, and support for measurement invariance across the Norwegian and a matched U.S. sample was found. Conclusively, the results indicate that scores on the Norwegian PID–5 have sound psychometric properties, which are substantially comparable with the original U.S. version, supporting its use in a Norwegian population.     

The Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version (MIST-A): Development of an Instrument for the Assessment of “Focused” and “Automatic” Hair Pulling

This article describes the development of the Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version (MIST-A), which was designed to assess “automatic” and “focused” pulling subtypes of trichotillomania (TTM). Participants reporting symptoms of TTM (n = 1,697) completed an internet survey; participants were later randomly assigned to either Exploratory (n = 848) or Confirmatory (n = 849) Analyses. Exploratory Analyses examined the development and psychometric properties of the MIST-A. Results of an exploratory factor analysis revealed a two-factor solution. Factor 1 (“focused” pulling scale) and 2 (“automatic” pulling scale) consisted of ten and five items respectively, with both scales demonstrating adequate internal consistency and good construct and discriminant validity. Subsequent confirmatory factor analysis demonstrated support for the scale’s underlying factor structure. The MIST-A provides researchers with a reliable and valid assessment of “automatic” and “focused” pulling, although replication using a clinically ascertained sample is necessary.

The “Authoritarian Personality” Reconsidered: the Phantom of “Left Fascism”*

The American Journal of Psychoanalysis - This article explores the question of “Left fascism,” which emerged in relation to discussions around the Student Movement in the German Federal...     

Evaluation of the PAI–A Anxiety and Depression Scales: Evidence of Construct Validity

Against the background of a dearth of studies examining the properties of the scale scores of the Personality Assessment Inventory–Adolescent (PAI–A; Morey, 2007), this study was conducted to evaluate evidence of construct validity for the Anxiety (ANX) and Depression (DEP) scales of the PAI–A. Convergent and discriminant validity of the ANX and DEP scale scores were investigated using a sample of adolescents admitted to the adolescent program of a private tertiary care inpatient treatment facility. Multiple methods assessing anxious and depressive symptomology and diagnoses were included. Construct validity of the ANX and DEP scales was mostly supported. Advantages of using the PAI–A for the assessment of anxiety and depression were discussed.     

The Shedler–Westen Assessment Procedure (SWAP): Making Personality Diagnosis Clinically Meaningful

A group of 38 severe anxiety patients and a group of 36 acute schizophrenic patients produced series of afterimages (AIs) of a simple, red stimulus. It was predicted that projective tendencies in these patients would be revealed by lack of stable congruence between AI color and stimulus. Symptoms of sensitivity together with results from the MCT (Meta-Contrast Technique) served as criteria in the anxiety group and symptoms of paranoia in the schizophrenic group. The hypothesis was affirmed: despite the unicolored stimulation, sensitive and paranoid subjects tended to report variegated A1s or A1s shifting from one color to another. It was concluded that, in case this plastic type of perception remains more or less permanent, it would serve as a fruitful breeding-ground for projective defenses.     

Development and Initial Validation of the Assessment of Motivational Interviewing Groups – Observer Scales (AMIGOS)

This article documents the development and initial validation of a global observer instrument, the Assessment of Motivational Interviewing Groups – Observer Scales (AMIGOS). The AMIGOS includes three scales composed of 18 items documenting group processes, client-centered style, and motivational interviewing (MI) change focus. Three experienced coders independently rated 18 sessions of various group approaches. The AMIGOS showed high inter-rater intraclass correlation coefficient (ICC) and Cronbach’s alpha, strong convergent and discriminant validity with the MI Treatment Integrity scales (MITI), the Therapist Empathy Scale (TES), and the Group Climate Questionnaire (GCQ). The AMIGOS shows promise as a reliable and valid measure of MI group leadership and group processes, and could be useful measuring other group therapies as well.     

The Validity and Clinical Utility of the Personality Inventory for DSM–5 Response Inconsistency Scale

The Personality Inventory for DSM–5 (PID–5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) is a self-report instrument designed to assess the personality traits of the alternative model of personality disorders (AMPD) in Section III of the DSM–5. Despite its relatively recent introduction to the field, the instrument is frequently and widely used. One criticism of this instrument is that it does not include validity scales to detect potentially invalidating response style, including noncredible over- and underreporting and inconsistent (random) responding. Keeley, Webb, Peterson, Roussin, and Flanagan (2016) constructed an inconsistency scale (the PID–5–INC) to assess random responding on PID–5 and proposed a number of potential cut scores that could be applied. In this study, we attempted to cross-validate the PID–5–INC, including whether the scale could detect randomly generated protocols and distinguish them from nonrandom protocols produced by two student and two clinical samples. The PID–5–INC successfully distinguished random from nonrandom protocols and the best cut scores were similar to those reported by Keeley et al. (2016). We also found that a relatively low amount of random responding compromised the psychometric validity of the PID–5 trait scales, which extended previous work on this instrument.     

Psychometric Properties of the Minnesota Multiphasic Personality Inventory–Adolescent (MMPI–A) Clinical,Content, and Supplementary Scales in a Forensic Sample

In this study, we evaluated the internal psychometric properties and external correlates of scores on the Clinical, Content, and Supplementary scales in a forensic sample of 496 adolescents (315 boys and 181 girls) who were court-ordered to receive psychological evaluations. We examined Cronbach's alpha coefficients, scale intercorrelation matrices, and frequencies of scale elevations. Further, we found varying degrees of support for the convergent and discriminant validity of scores on the MMPI–A (Butcher et al., 1992 Butcher, J. N., Williams, C. L., Graham, J. R., Archer, R. P., Tellegen, A., Ben-Porath, Y. S. and Kaemmer, B. 1992. MMPI–A (Minnesota Multiphasic Personality Inventory–Adolescent): Manual for administration, scoring, and interpretation, Minneapolis: University of Minnesota Press.  [Google Scholar]) Clinical, Content, and Supplementary scales. This study adds to the body of literature establishing the utility of the MMPI–A in forensic evaluations.     

Relations Between Minnesota Multiphasic Personality Inventory–A Scales and Rorschach Variables With the Scope and Severity of Maltreatment Among Adolescents

This study examined preexisting Rorschach (Exner, 2001) and Minnesota Multiphasic Personality Inventory–A (MMPI–A; Butcher et al., 1992) profiles to determine if selected MMPI–A scales and Rorschach variables would jointly associate with the number and severity of maltreatment subtypes (physical abuse, sexual abuse, neglect, and emotional maltreatment) of 157 adolescents (ages 14–17) with documented maltreatment histories. The Maltreatment Classification System was used to systematically code the maltreatment attributes. Six Rorschach variables (MOR, PER, Afr, SumY, SumC’, Human Content) were significantly correlated with the number of maltreatment subtypes, but none of the anticipated MMPI–A scales were related. MMPI–A Scale 7 and Rorschach variables Ego, MOR, and PER were jointly associated with physical abuse severity. MMPI–A Scale 0 and Rorschach variables MOR, PER, SumY, SumC’, PTI, Human Content, and Texture jointly associated with sexual abuse severity. This study supports the potential for certain MMPI–A scales and Rorschach variables to reflect the impact of adolescents’ maltreatment experiences in terms of the number and severity of types of maltreatment experienced. Because both instruments captured different aspects of adolescents’ maltreatment experiences, clinicians should consider using both when evaluating the impact of maltreatment on adolescents.