The Utility of the Personality Assessment Inventory in the Assessment of Posttraumatic Stress Disorder in OEF/OIF/OND Veterans

Abstract

We examined the use of the Personality Assessment Inventory (PAI) in a small sample of 47 U.S. military veterans of the conflicts in Iraq and Afghanistan. Approximately half of the sample met criteria for posttraumatic stress disorder (PTSD) based on the Clinician-Administered PTSD Scale. PAI profiles were compared between the PTSD and non-PTSD groups. The PTSD group had clinically significant scores (≥ 70T) on the PAI for 5 clinical scales (anxiety, anxiety-related disorders, depression, paranoia, and schizophrenia) and 10 clinical subscales consistent with the typical symptom picture for PTSD. Effect size correlations (r) between scales and diagnosis group membership were large (r ≥ .5) for several scales that reflect PTSD symptoms and for the PTSD LOGIT function. In a receiver operating characteristics curve analysis, the PTSD LOGIT function and the Traumatic Stress Subscale both demonstrated good diagnostic utility (areas under the curve > .80).

Keywords

personality assessment inventory posttraumatic stress disorder veterans

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Beckham

J. C.

Feldman

M. E.

Kirby

A. C.

Hertzberg

M. A.

Moore

S. D.

(1997). Interpersonal violence and its correlates in Vietnam veterans with chronic posttraumatic stress disorder. Journal of Clinical Psychology, 53, 859-869. doi:10.1002/(SICI)1097-4679(199712)53:8<859::AID-JCLP11>3.0.CO;2-J

Begic

Jokic-Begic

(2001). Aggressive behavior in combat veterans with post-traumatic stress disorder. Military Medicine, 166, 671-676.

Blake

D. D.

Weathers

F. W.

Nagy

L. M.

Kaloupek

D. G.

Gusman

F. D.

Charney

D. S.

Keane

T. M.

(1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 75-90. doi:10.1002/jts.2490080106

Brady

K. T.

Killeen

T. K.

Brewerton

Lucerini

(2000). Comorbidity of psychiatric disorders and posttraumatic stress disorder. Journal of Clinical Psychiatry, 61, 22-32. doi:10.5772/26689

Busse

Whiteside

Waters

Hellings

(2014). Exploring the reliability and component structure of the Personality Assessment Inventory in a neuropsychological sample. The Clinical Neuropsychologist, 28, 237-251. doi:10.1080/13854046.2013.876100

Calhoun

P. S.

Beckham

J. C.

Feldman

M. E.

Barefoot

J. C.

Haney

Bosworth

H. B.

(2002). Partners’ ratings of combat veterans’ anger. Journal of Traumatic Stress, 15, 133-136. doi:10.1023/A:1014808008142

Calhoun

P. S.

Boggs

C. D.

Crawford

E. F.

Beckham

J. C.

(2009). Diagnostic efficiency of the Personality Assessment Inventory LOGIT function for posttraumatic stress disorder in women. Journal of Personality Assessment, 91, 409-415. doi:10.1080/00223890903087497

Calhoun

P. S.

Collie

C. F.

Clancy

C. P.

Braxton

L. E.

Beckham

J. C.

(2010). Use of the PAI in assessment of posttraumatic stress disorder among help-seeking veterans. In Blais

M. A.

Baity

M. R.

Hopwood

C. J.

(Eds.), Clinical applications of the personality assessment inventory (pp. 93-111). New York, NY: Routledge.

10.

Calhoun

P. S.

Earnst

K. S.

Tucker

D. D.

Kirby

A. C.

Beckham

J. C.

(2000). Feigning combat-related posttraumatic stress disorder on the Personality Assessment Inventory. Journal of Personality Assessment, 75, 338-350. doi:10.1207/S15327752JPA7502_11

11.

Cherepon

J. A.

Prinzhorn

(1994). Personality Assessment Inventory (PAI) profiles of adult female abuse survivors. Assessment, 1, 393-399. doi:10.1177/107319119400100408

12.

Crawford

E. F

Calhoun

P. S.

Braxton

L. E.

Beckham

J. C.

(2007). Validity of the Personality Assessment Inventory aggression scales and violence potential index in veterans with PTSD. Journal of Personality Assessment, 88, 90-98. doi:10.1080/00223890709336839

13.

Drury

Calhoun

P. S.

Boggs

Araujo

Dennis

M. F.

Beckham

J. C.

(2009). Influences of comorbid disorders on Personality Assessment Inventory profiles in women with posttraumatic stress disorder. Journal of Psychopathological Behavior Assessment, 31, 119-128. doi:10.1007/s10862-008-9101-5

14.

Epidemiology Program, Post-Deployment Health Group, Office of Public Health, Veterans Health Administration, Department of Veterans Affairs. (2015). Analysis of VA health care utilization among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans. Washington, DC: Author. Retrieved from http://www.publichealth.va.gov/docs/epidemiology/healthcare-utilization-report-fy2015-qtr2.pdf

15.

Forbes

Creamer

Biddle

(2001). The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD. Behavior Research and Therapy, 39, 977-986. doi:10.1016/S0005-7967(00)00084-X

16.

Freeman

T. W.

Roca

(2001). Gun use, attitudes toward violence, and aggression among combat veterans with chronic posttraumatic stress disorder. Journal of Nervous and Mental Disease, 189, 317-320. doi:10.1097/00005053-200105000-00008

17.

Holmes

G. E.

Williams

C. L.

Haines

(2001). Motor vehicle accident trauma exposure: Personality profiles associated with posttraumatic diagnoses. Anxiety, Stress & Coping, 14, 301-313. doi:10.1080/10615800108248359

18.

Hopwood

C. J.

Baker

K. L.

Morey

L. C.

(2008). Extratest validity of selected Personality Assessment Inventory scales and indicators in an inpatient substance abuse setting. Journal of Personality Assessment, 90, 574-577. doi:10.1080/00223890802388533

19.

Kessler

R. C.

Chiu

W. T.

Demler

Walters

E. E.

(2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 617-627. doi:10.1001/archpsyc.62.6.617

20.

Kessler

R. C.

Sonnega

Bromet

Hughes

Nelson

C. B.

(1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048-1060. doi:10.1001/archpsyc.1995.03950240066012

21.

McDevitt-Murphy

M. E.

Murphy

J. G.

Monahan

C. J.

Flood

A. M.

. . . Weathers

F. W.

(2010). Unique patterns of substance misuse associated with PTSD, depression, and social phobia. Journal of Dual Diagnosis, 6, 94-110. doi:10.1080/15504261003701445

22.

McDevitt-Murphy

M. E.

Weathers

F. W.

Adkins

J. W.

Daniels

J. B.

(2005). Use of the Personality Assessment Inventory in assessment of posttraumatic stress disorder in women. Journal of Psychopathology and Behavioral Assessment, 27, 57-65. doi:10.1007/s10862-005-5380-2

23.

McDevitt-Murphy

M. E.

Weathers

F. W.

Flood

A. M.

Eakin

D. E.

Benson

T. A.

(2007). The utility of the PAI and the MMPI-2 for discriminating PTSD, depression, and social phobia in trauma-exposed college students. Assessment, 14, 181-195. doi:10.1177/1073191106295914

24.

McFall

Fontana

Raskind

Rosenbeck

(1999). Analysis of violent behavior in Vietnam combat veteran psychiatric inpatients with posttraumatic stress disorder. Journal of Traumatic Stress, 12, 501-517. doi:10.1023/A:1024771121189

25.

McFall

Wright

P. W.

Donavan

D. M.

Raskind

(1999). Multidimensional assessment of anger in Vietnam veterans with posttraumatic stress disorder. Comprehensive Psychiatry, 40, 216-220. doi:10.1016/S0010-440X(99)90006-8

26.

Morey

L. C.

(1991). Personality Assessment Inventory: Professional manual. Lutz, FL: Psychological Assessment Resources.

27.

Morey

L. C.

(1996). An interpretive guide to the Personality Assessment Inventory. Odessa, FL: Psychological Assessment Resources.

28.

Mozley

S. L.

Miller

M. W.

Weathers

F. W.

Beckham

J. C.

Feldman

M. E.

(2005). Personality Assessment Inventory (PAI) profiles of male veterans with combat-related posttraumatic stress disorder. Journal of Psychopathology and Behavioral Assessment, 27, 179-189. doi:10.1080%2F00223890903087497

29.

Parker

J. D.

Daleiden

E. L.

Simpson

C. A.

(1999). Personality Assessment Inventory substance-use scales: Convergent and discriminant relations with the addiction severity index in a residential chemical dependence treatment setting. Psychological Assessment, 114, 507-513. doi:10.1037/1040-3590.11.4.507

30.

Patry

M. W.

Magaletta

P. R.

(2014). Measuring suicidality using the Personality Assessment Inventory: A convergent validity study with federal inmates. Assessment, 22, 36-45. doi:10.1177/1073191114539381

31.

Patry

M. W.

Magaletta

P. R.

Diamond

P. M.

Weinman

B. A.

(2011). Establishing the validity of the Personality Assessment Inventory drug and alcohol scales in a corrections sample. Assessment, 18, 50-59. doi:10.1177/1073191110368484

32.

Rosenthal

Rosnow

R. L.

Rubin

D. B.

(2000). Contrasts and effect sizes in behavioral research: A correlational approach. New York, NY: Cambridge University Press.

33.

Seal

Metzler

T. J.

Gima

K. S.

Bertenthal

Maguen

Marmar

C. R.

(2009). Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs Health Care, 2002-2008. American Journal of Public Health, 99, 1651-1658. doi:10.2105/AJPH.2008.150284

34.

Tabachnick

B. G.

Fidell

L. S.

(2006). Using multivariate statistics (5th ed.). Needham Heights, MA: Allyn & Bacon.

35.

Tanielian

Jaycox

L. H.

(2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: RAND.

36.

Trivedi

R. B.

Post

E. P.

Sun

Pomerantz

Saxon

Piette

J. D.

. . . Nelson

(2015). Prevalence, comorbidity and prognosis of mental health among US veterans. American Journal of Public Health, 105, 2564-2569. doi:10.2105/AJPH.2015.302836

37.

Van Voorhees

E. E.

Dennis

P. A.

Elbogen

E. B.

Clancy

C. P.

Hertzberg

M. A.

Beckham

J. C.

Calhoun

P. S

. (2014). Personality Assessment Inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: Associations with aggression. Aggressive Behavior, 40, 582-592. doi:10.1002/ab.21554

38.

Weathers

F. W.

Keane

T. M.

Davidson

J. R.

(2001). Clinician-Administered PTSD Scale: A review of the first ten years of research. Depression and Anxiety, 13, 132-156. doi:10.1037/t00072-000

39.

Weathers

F. W.

Litz

B. T.

Herman

D. S.

Huska

J. A.

Keane

T. M.

(1993, October). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the annual meeting of the International Society for Traumatic Stress Studies, San Antonio, TX.