The search for dimensional structure differences between normality and abnormality: a statistical review of published data on personality and psychopathology

A statistical review of published data for 37 personality and psychopathology inventories was conducted to determine whether there are dimensional structure differences between clinical and nonclinical respondents. Correlation and factor-loading matrices from multiscale inventories and from specialized measures were tested for structural invariance across populations. There was relatively consistent evidence for high levels of similarity between normal and abnormal populations both in the number of factors that exist in the data matrices and in the factor patterns. The dimensional universes of normality and abnormality are apparently the same, at least according to data derived from contemporary assessment instruments. Categorical-taxonic differences between clinical and nonclinical populations, which were not examined, may nevertheless exist within contexts of dimensional structure similarity.     

Evidence-based assessment of personality disorders

The purpose of this article is to provide a foundation for the development of evidence-based guidelines for the assessment of personality disorders, focusing in particular on integrated assessment strategies. The general strategy recommended herein is to first administer a self-report inventory to alert oneself to the potential presence of particular maladaptive personality traits followed by a semistructured interview to verify their presence. This strategy is guided by the existing research that suggests particular strengths of self-report inventories and semistructured interviews relative to unstructured clinical interviews. However, the authors also consider research that suggests that further improvements to the existing instruments can be made. The authors emphasize, in particular, a consideration of age of onset, distortions in self-perception and presentation, gender bias, culture and ethnicity, and personality change.     

A survey of psychological test use patterns among forensic psychologists

Clinical psychologists are frequently called on to testify in court regarding mental health issues in civil or criminal cases. One of the legal criteria by which admissibility of testimony is determined includes whether the testimony is based on methods that have gained "general acceptance" in their field. In this study, we sought to evaluate the psychological tests used in forensic assessments by members of the American Psychology-Law Society Division of the American Psychological Association, and by diplomates in the American Board of Forensic Psychology. We present test results from this survey, based on 152 respondents, for forensic evaluations conducted with adults using multiscale inventories, single-scale tests, unstructured personality tests, cognitive and/or intellectual tests, neuropsychological tests, risk assessment and psychopathy instruments, sex offender risk assessment instruments, competency or sanity-related instruments, and instruments used to evaluate malingering. In addition, we provide findings for psychological testing involving child-related forensic issues.     

Indigenous measures of personality assessment in Asian countries: a review

This article reviews attempts to develop multidimensional personality measures in Asia and their applications in clinical assessment. Indigenous personality assessment measures in India, Korea, Japan, the Philippines, and Taiwan are examined. These early attempts have not yielded a comprehensive personality measure that integrates a theoretical framework and an empirical program of validation. The Chinese Personality Assessment Inventory (CPAI) is cited as an example to illustrate the process of developing an indigenous measure that meets the testing standards of established assessment instruments. On the basis of the research findings from the CPAI, the authors discuss the relevance of indigenous measures in clinical assessment in native cultures as well as in informing mainstream personality assessment.     

Applications of Personality Assessment to the Workplace: A Review

Our review of the relevant research literature in the recent past strongly supports the view that personality assessment has high utility in the workplace. We review the evidence that personality assessment measures, especially those based upon the Big Five factors of personality, can effectively predict job performance and thus can be used for personnel selection. The validity of integrity testing in predicting counterproductivity on the job has been demonstrated both for overt measures of integrity and, to a lesser degree, for more general (subtle) measures of personality. We also found good evidence of validity for measures of (supervisory) management and (transformational) leadership, a complex field which includes a number of multidimensional instruments each built around its own theory. Finally, we review the empirical literature that supports the use of assessment centers and the use of personality assessment in training and development.     

A factorial study of the multiphasic,strong, kuder,and bell inventories using a population of adult males

In a centroid factor analysis of the Multiphasic, Strong, Kuder, and Bell inventories using a population of 400 adult males, eight common factors dealing with aspects of personality as measured by these instruments were isolated. Seven of the factors were meaningful and one was a residual. This study indicates little overlap between the two personality and the two interest inventories. It would appear that factors found in these instruments measuring aspects of personality are dichotomous in nature and are not common to the two types of instruments included in this study. That is, two of the factors were common to the two personality inventories, and five of the factors were common to the two interest inventories.Abstract of dissertation submitted at Syracuse University, January, 1949, in partial fulfillment of requirements for the degree of Doctor of Education.     

A very brief measure of the Big-Five personality domains

When time is limited, researchers may be faced with the choice of using an extremely brief measure of the Big-Five personality dimensions or using no measure at all. To meet the need for a very brief measure, 5 and 10-item inventories were developed and evaluated. Although somewhat inferior to standard multi-item instruments, the instruments reached adequate levels in terms of: (a) convergence with widely used Big-Five measures in self, observer, and peer reports, (b) test–retest reliability, (c) patterns of predicted external correlates, and (d) convergence between self and observer ratings. On the basis of these tests, a 10-item measure of the Big-Five dimensions is offered for situations where very short measures are needed, personality is not the primary topic of interest, or researchers can tolerate the somewhat diminished psychometric properties associated with very brief measures.     

Is Veteran Status and Suicide Risk Assessed in Community Long‐Term Care? A Review of the States' Assessment Instruments

Given recent policy initiatives to address suicide risk among older persons and veterans, community‐based elder serving agencies may serve an important role in identifying and referring individuals at risk for suicide. A review of state‐level long‐term assessment instruments was conducted to determine whether veteran status and suicide are assessed. Data from forty‐three state's Units on Aging instruments were content analyzed. Results indicate that over two thirds of the states in this review included questions about suicide and veterans in their assessments, 69.8% and 67.4% respectively. Suicide risk among elders and veterans must be addressed at local, state, and federal levels so that concerted attention and oversight can be provided for matching elders to the services they need.     

Addressing Concealed Suicidality: A Flexible and Contextual Approach to Suicide Risk Assessment in Adults

Concealed suicidality can be a major impediment for clinicians conducting a suicide risk assessment. Client minimization and denial of suicidal thoughts can lead clinicians to undertreat and under-monitor clients experiencing a suicidal crisis. Five recommendations are given to address potential weak areas of suicide assessment with adults including routinized processes and a reliance on assessment instruments that may underestimate risk when individuals have no prior attempts or significant mental illness. Specifically, the authors highlight the importance of continued training and education in suicide assessment, how considering the context of the assessment can heighten one’s sensitivity to concealment of suicidal ideation and how different assessment instruments and interview techniques, when chosen with care, can increase the candor of client expression. The authors also recommend attending to clinician anxiety both as a way of maintaining rapport as well as a method of identifying clues that the assessment is not producing accurate information. Finally, application of recommendations is demonstrated through case vignettes.

     

The Family of Instruments That Assess Suicide Risk

In suicide assessment, Becks Scale for Suicide Ideation is used widely, though other adult and youth instruments are available. A creative, positive instrument is the Reasons for Living. Advantages of suicide questionnaires include rapid assessment, access to information that may be difficult to obtain by observations and verbal interaction, ease of completion for some, availability of established norms for some instruments, and indirect information provided by questionnaire responding. Disadvantages are the temptation to accept responses uncritically, the possibility that therapists or clients view the questionnaires as superseding the therapeutic relationship, the implication that suicide tendencies are static, and, at times, cost. Overall, sound clinical judgment is paramount when assessing for suicide.     

Measuring motivation multidimensionally: development of the Assessment of Individual Motives-Questionnaire (AIM-Q)

We report the development of the Assessment of Individual Motives-Questionnaire (AIM-Q), a new instrument based on an evolutionary psychology theory of human motivation. It provides multitrait-multimethod (MTMM) assessment of individual differences on 15 motive scales. A total heterogeneous sample of N = 1,251 participated in eight studies that evaluated the homogeneity, internal consistency, test-retest reliability, and MTMM convergent and discriminant validities of the AIM-Q's three methods. These studies generally support the overall strategy of assessing individual differences in multiple evolutionary-based motives with multiple methods. Additional validity studies are underway and, when validated further, the AIM-Q may offer a promising option for evolutionary psychologists and behavioral geneticists wanting to incorporate individual differences into their research but have had to use existing self-report measures of personality, which were not designed for such a purpose. It may also offer clinical and counseling psychologists an additional approach to personality measures for the prediction of behavior.     

Toward a model for assessing level of personality functioning in DSM-5, part I: a review of theory and methods

Personality disorders are associated with fundamental disturbances of self and interpersonal relations, problems that vary in severity within and across disorders. This review surveyed clinician-rated measures of personality psychopathology that focus on self-other dimensions to explore the feasibility and utility of constructing a scale of severity of impairment in personality functioning for DSM-5. Robust elements of the instruments were considered in creating a continuum of personality functioning based on aspects of identity, self-direction, empathy, and intimacy. Building on preliminary findings (Morey et al., 2011 /this issue), the proposed Levels of Personality Functioning will be subjected to extensive empirical testing in the DSM-5 field trials and elsewhere. The resulting version of this severity measure is expected to have clinical utility in identifying personality psychopathology, planning treatment, building the therapeutic alliance, and studying treatment course and outcome.     

Assessment of acquired capability for suicide in clinical practice

The Interpersonal Psychological Theory of suicide proposes that the interaction between Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide (ACS) predicts proximal risk of death by suicide. Instruments to assess all three constructs are available. However, research on the validity of one of them, the acquired capability for suicide scale (ACSS), has been limited, especially in terms of its clinical relevance. This study aimed to explore the utility of the different versions of the ACSS in clinical assessment. Three versions of the scale were investigated, the full 20-item version, a 7-item version and a single item version representing self-perceived capability for suicide. In a sample of patients recruited from a clinic specialising in the treatment of suicidality and in a community sample, all versions of the ACSS were found to show reasonable levels of reliability and to correlate as expected with reports of suicidal ideation, self-harm, and attempted suicide. The item assessing self-perceived acquired capacity for suicide showed highest correlations with all levels of suicidal behaviour. However, no version of the ACSS on its own showed a capacity to indicate suicide attempts in the combined sample. It is concluded that the versions of the scale have construct validity, but their clinical utility is limited. An assessment using a single item on self-perceived ACS outperforms the full and shortened versions of ACSS in clinical settings and can be recommended with caution for clinicians interested in assessing this characteristic.     

Suicide risk assessment: Clinicians’ confidence in their professional judgment

Suicide risk assessment is a critical component of mental health practice for which the stakes are high and the outcomes uncertain. This research examines the consistency with which clinicians make determinations of suicide risk and factors influencing clinical confidence. Seventy-one social workers interviewed two standardized patients performing in scenarios depicting suicidal ideation, judged whether the patient required hospitalization, and completed standardized suicide risk assessment measures. Self-ratings and qualitative interviews explored participants’ confidence in their judgment of risk. Participants had highly divergent views regarding whether or not the risk of suicide was sufficiently high to require hospitalization. However, regardless of the ultimate decision reached, participants were equally confident when recommending either clinical course of action. The variation in risk assessment appraisals in this study, despite at times high rates of confidence in risk appraisals, speaks to the need for ongoing training, consultation, and increased decision support strategies.     

Outcome measures for clinical drug trials in autism

This paper identifies instruments and measures that may be appropriate for randomized clinical trials in participants with autism spectrum disorders (ASDs). The Clinical Global Impressions scale was recommended for all randomized clinical trials. At this point, however, there is no "perfect" choice of outcome measure for core features of autism, although we will discuss five measures of potential utility. Several communication instruments are recommended, based in part on suitability across the age range. In trials where the intention is to alter core features of ASDs, adaptive behavior scales are also worthy of consideration. Several "behavior complexes" common to ASDs are identified, and instruments are recommended for assessment of these. Given the prevalence of cognitive impairment in ASDs, it is important to assess any cognitive effects, although cognitive data from ASD randomized clinical trials, thus far, are minimal. Guidance from trials in related pharmacologic areas and behavioral pharmacology may be helpful. We recommend routine elicitation of side effects, height and weight, vital signs, and (in the case of antipsychotics) extrapyramidal side-effects assessment. It is often appropriate to include laboratory tests and assessments for continence and sleep pattern.     

Incremental validity and the assessment of psychopathology in adults

Results from studies on incremental validity are described for (a) interviews, (b) personality inventories, (c) projective techniques, and (d) brief self-rated and clinician-rated measures. In some of the studies (clinical judgment studies), psychologists were given increasing amounts of information. In other studies (statistical prediction studies), increasing amounts of assessment information were entered into a statistical prediction rule. Although relatively little research has been conducted on incremental validity, results that have been obtained tend to favor the use of interviews, personality inventories (e.g., the Minnesota Multiphasic Personality Inventory--2; J. N. Butcher, W. G. Dahlstrom, J. R., Graham, A. Tellegen, & B. Kaemmer, 1989), and brief self-rated measures (e.g., the Anxiety Sensitivity Index, S. Reiss, R. A. Peterson, D. M. Gursky, & R. M. McNally, 1986). Results are generally less encouraging for projective techniques.     

Examining the Utility of General Models of Personality in the Study of Psychopathy: A Comparison of the HEXACO-PI-R and NEO PI-R

The Five-Factor model is one of the most popular models of general personality but recently a competing model, the HEXACO, has been put forth as an alternative. In the current study, we compare the two models by examining the interrelations between their primary measures, the Revised NEO Personality Inventory (NEO PI-R) and the Revised HEXACO Personality Inventory (HEXACO-PI-R), and their relations with psychopathy in a sample of undergraduates (N = 290). Results revealed good convergence between conceptually related personality traits. Both inventories accounted for substantial proportions of variance in psychopathy scores although the HEXACO-PI-R accounted for a larger proportion. The findings are discussed in relation to the HEXACO domain of Emotionality, which functions differently than NEO PI-R Neuroticism. The results suggest that both measures assess psychopathy-related traits, but the HEXACO-PI-R may offer a slight advantage.