Personality Assessment Screener in a Primary Care Sample of Low-Income Urban Women

Convergent and Discriminant Validity of Personality Inventory for DSM-5-BF in a Primary Care Sample

A growing body of research supports the validity of the Personality Inventory for DSM-5 (PID-5) in evaluating community and psychiatric samples. Although maladaptive personality also has significant relevance in primary care settings, research on the PID-5 in primary care samples is limited. In this study, the authors examined the intercorrelations, convergent validity, and discriminant validity of the brief form of the PID-5 (PID-5-BF) in 100 primary care outpatients. Results are consistent with findings in other samples in suggesting that PID-5 domains are moderately intercorrelated and associated with a variety of mental health variables. Smaller associations with physical health variables support the discriminant validity of the instrument. Overall, results suggest that the PID-5-BF can provide a useful psychiatric screening tool in primary care settings.

The Multidimensional Behavioral Health Screen 1.0: A Translational Tool for Primary Medical Care

The Multidimensional Behavioral Health Screen (MBHS) is a brief, 27-item questionnaire designed for screening every patient in primary medical care settings. It measures nine psychopathology constructs that represent the major distinctive core dimensions of the types of behavioral health symptoms most commonly encountered in primary care (anxiety-related, depressive, and attention/cognitive symptoms). The underlying design of the MBHS is based on the major paradigm shift that has occurred in the field of theoretical psychopathology, replacing categorical syndromes, or "disorders," with hierarchical-dimensional constructs. Existing screening tests such as the PHQ-9 and GAD-7 are based explicitly on the categorical paradigm and thus suffer from the same (numerous) shortcomings as the categorical model itself. The dimensional paradigm supports enhanced measurement precision with very short scales. The goals of the MBHS are threefold: (1) to provide accurate, treatment-relevant behavioral health information to the medical provider; (2) to provide clear referral cut-points; (3) to contribute nine psychometrically sound behavioral health variables to the "healthcare big data cloud" to support future scholarship of discovery. Presented here are the basic psychometric properties of the MBHS, including reliability, convergent and discriminant validity, and classification accuracy, as well as implementation considerations.

Three validation studies of the personality assessment inventory short form

OBJECTIVE

We examined the psychometric properties of the Personality Assessment Inventory-Short Form (PAI-SF).

METHOD

Study 1 compared single-session short and full form PAI profiles of 200 outpatients, Study 2 examined PAI forms of 107 nonclinical adults across two administrations, and Study 3 compared correlations between full and short form scales and extratest variables.

RESULTS

Study 1 correlations between short and full form scales ranged from 0.85 to 0.95 (Mdn = 0.91), with lower correlations, ranging from 0.59 to 0.86 for clinical scales (Mdn = 0.82), in Study 2. In Study 3 only 4 of 34 correlations differed significantly between extratest variables and the PAI versus the PAI-SF.

CONCLUSIONS

These results indicate favorable psychometric properties of the PAI-SF.

Assessing Level of Personality Organization With the Psychodiagnostic Chart: A Validity Study

Heterogeneity within diagnostic types and comorbidity across diagnostic groups render a specific personality disorder anything but specific, leading researchers and clinicians to increasingly focus on the general severity of personality pathology. Personality pathology severity is reflected in one's level of personality organization (LPO) and research has demonstrated that LPO is a significant predictor of treatment response. This investigation examined the reliability and validity of the Psychodiagnostic Chart (PDC) in assessing the LPO dimension of the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006). Among a sample of 88 urban-dwelling women seeking primary medical care, the LPO dimension of the PDC received fair to good interrater reliability among 6 psychodynamic psychologists. Convergent validity was demonstrated with contrast analysis and individual correlations that yielded statistically significant associations between LPO scores and conceptually related psychodynamic variables (e.g., defensive functioning, object relations) and self-reported personality pathology scores. Support for discriminant validity was limited by the modest power associated with the sample size. Exploratory analyses examining LPO scores and measures of physical health and intimate partner violence were conducted. Our results supported the reliability, validity, and practical use of the LPO dimension of the PDC.

Childhood Abuse Is Associated With Worse Survival Following Lung Transplantation

CONTEXT

Psychosocial factors can impact lung transplant outcomes. However, it is currently unknown whether abuse survivorship influences lung transplant survival.

OBJECTIVE

To characterize the abuse history of adult lung transplant patients and determine whether such history is associated with mortality.

PATIENTS AND OTHER PARTICIPANTS

Adult lung transplant recipients evaluated from 2000 to 2004.

MAIN OUTCOME MEASURES

The main outcome was post-lung transplantation survival. The secondary outcomes included demographic, transplantation, or psychological assessment differences between those with a history of abuse survivorship and those without.

RESULTS

Thirty-three lung transplant recipients (35.5% male, median age: 55 years) were included. A history of abuse survivorship was common (24.2%) and was associated with decreased survival following lung transplantation (P = .003). There was no difference in sex, marital status, or smoking history between abuse survivors and those who denied being the victim of abuse. Abuse survivors had a higher Personality Assessment Screener total score, a measure of maladaptive personality traits (P = .02).

CONCLUSION

Abuse survivorship is common in lung transplant patients and associated with increased posttransplant mortality and increased maladaptive personality traits. This preliminary evidence suggests that lung transplant patients should be screened for abuse history and provided with appropriate treatment of survivorship issues to potentially improve their health outcomes from transplantation.

Convergence of Self-Reports and Informant Reports on the Personality Assessment Screener

The present study is the first to investigate the Personality Assessment Screener, a brief self-report measure of risk for emotional and behavioral dysfunction, in relation to the informant report version of this instrument, the Personality Assessment Screener–Other. Among a sample of undergraduate roommate dyads ( N = 174), self-report and informant report total scores on the Personality Assessment Screener/Personality Assessment Screener–Other moderately converged ( r = 0.45), with generally greater agreement between perspectives observed for externalizing behaviors compared with internalizing distress. In addition, selves tended to report more psychological difficulties relative to informant ratings ( d = 0.45) with an average absolute discrepancy between sources of 6.31 ( SD = 4.96) out of a possible range of 66. Discrepancies between self-report and informant report were significantly associated with characteristics of the dyadic relationship (e.g., length of acquaintanceship) as well as the severity of self-reported psychological difficulties and positive impression management.

Personality Assessment Screener, Childhood Abuse, and Adult Partner Violence in African American Women Using Primary Care

This study assessed the relationship between psychopathology with the Personality Assessment Screener (PAS) and childhood physical and sexual abuse and adult physical and sexual partner violence in a primary care sample of 98 urban-dwelling African American women. Patients completed the PAS, the Childhood Trauma Questionnaire, and the Conflict Tactics Scale. The PAS total score significantly correlated with all measures of childhood and adult abuse. Stepwise regression analyses revealed that PAS element scores of Suicidal Thinking and Hostile Control significantly predicted a history of childhood physical abuse; Suicidal Thinking, Hostile Control, and Acting Out significantly predicted a history of childhood sexual abuse; Suicidal Thinking, Negative Affect, and Alienation significantly predicted current adult partner physical violence; and Psychotic Features, Alcohol Problems, and Anger Control significantly predicted current adult sexual partner violence. The PAS appears to be a useful measure for fast-paced primary care settings for identifying patients who need a more thorough assessment for abuse.