Introduction to PAI - Clinical Scales and Subscales

Clinical Scales - Ranges

Common Ranges (each scale may differ)

• 59T or less (no difficulty)

• 60T to 69T (No to Moderate difficulty)

  • Upper end is 65T to 68T (mild to moderate difficulty)

• 70T or more (moderate difficultly)

  • Clinically relevant elevation

• 82T or more (significant difficulty)

Clinical Scales

• Somatic Complaints (SOM)

• Anxiety (ANX)

• Anxiety-Related Disorders (ARD)

• Depression (DEP)

• Mania (MAN)

• Paranoia (PAR)

• Schizophrenia (SCZ)

• Borderline Features (BOR)

• Antisocial Features (ANT)

• Alcohol Problems (ALC)

• Drug Problems (DRG)

Somatic Complaints (SOM)

Preoccupation with health matters and somatic complaints

• 59T or less indicates few bodily or somatic complaints.

• 60T to 69T some concerns; medical patients or elderly

• ≥ 70T significant concerns and impairment from somatic concerns/complaints

• ≥ 88T wide array of somatic concerns

SOM Subscales

• SOM-C: Conversion

• SOM-S: Somatization

• SOM-H: Health Concerns

Anxiety (ANX)

Observable signs of anxiety

• ≤ 59T few complaints of anxiety, worry or tension.

• 60T to 69T some worry, sensitivity and/or tension

• ≥70T significant anxiety, worry and/or tension

• ≥91T generalized impairment associated with anxiety

ANX Subscales

• ANX-C: Cognitive

  • Rumination

• ANX-A: Affective

  • Difficulty relaxing

• ANX-P: Physiological

Anxiety-Related Disorders (ARD)

Focus on symptoms and behaviors related to specific anxiety disorders

• ≤ 59T little distress across many situations

• 60T to 69T little confidence and worry

• ≥ 70T suggests impairment associated with anxiety related condition(s)

• ≥ 91T or higher likely to reflect multiple anxiety disorder diagnosis

ARD Subscales

• ARD-O: Obsessive-Compulsive

• ARD-P: Phobias

• ARD-T: Traumatic Stress

• Most likely to see higher scores on one of the subscales than all three or the main scale because each one is getting at one specific disorder.

Depression (DEP)

Focus on symptoms of depressive disorder

• ≤ 59T few complaints about unhappiness or distress

• 60T - 69T some unhappiness, sensitivity, pessimism, and/or self-doubt

• ≥ 70T significant dysphoria

• ≥ 81T indicative of major depressive episode.

DEP Subscales

• DEP-C: Cognitive

• DEP-A: Affective

  • Feelings of sadness

• DEP-P: Physiological

Mania (MAN)

Focus on affective, cognitive, and behavioral symptoms of mania and hypomania

• ≤ 54T little endorsement of mania/hypomania

• 55T - 64T active, outgoing, ambitious, and self-confident

• 65T - 74T increasing restlessness, impulsivity, and high energy levels

• ≥ 75T mania, hypomania or cyclothymia

• Someone with mania would have difficulty completing the tool

MAN Subscales

• MAN-A: Activity Level

• MAN-G: Grandiosity

• MAN-I: Irritability

Paranoia (PAR)

Symptoms of paranoid disorders and characteristics of paranoid personality

• ≤ 59T likely to be open/forgiving in relationships.

• 60T - 69T may be seen as sensitive, tough-minded, and skeptical

• ≥ 70T likely to be overtly suspicious and hostile; distrustful

• ≥ 84T paranoia of a potentially delusional proportion

PAR Subscales

• PAR-H: Hypervigilance

• PAR-P: Persecution

• PAR-R: Resentment

Schizophrenia (SCZ)

Symptoms relevant to broad spectrum of schizophrenic disorders

• ≤ 59T reports being effective in social relationships, no concentration difficulties

• 60T - 69T may be withdrawn, aloof, unconventional; Upper end: cautious/hostile in relationships

• ≥ 70T likely to be isolated, thinking difficulties, concentration, attention or decision-making are likely

• ≥ 90T may be active schizophrenic episode

SCZ Subscales

• SCZ-P: Psychotic Experiences

• SCZ-S: Social Detachment

• SCZ-T: Thought Disorder

  • Difficulty concentrating, disorganized thoughts

• It is possible for social detachment to be high and not the others.

  • Might be looking at someone who is isolated, depressed, etc.

Borderline Features (BOR)

Attributes of borderline type personality functioning

• ≤59T person reports being emotionally stable, stable relationships

• 60T to 69T may be moody, sensitive, with uncertainty

• ≥ 70T likely to be impulsive and emotionally labile

• ≥ 92T personality functioning within the borderline

BOR Subscales

• BOR-A: Affective Instability

• BOR-I: Identity Problems

• BOR-N: Negative Relationships

• BOR-S: Self-Harm

Antisocial Features (ANT)

History of acts and authority problems, egocentrism, lack of empathy/loyalty, instability and excitement-seeking

• ≤ 59T reports being empathetic, warm in relationships

• 60T - 69T impulsive, risk taker

• ≥ 70T hostility and impulsiveness likely

• ≥ 82T prominent features of ASPD

ANT Subscales

• ANT-A: Antisocial Behaviors

• ANT-E: Egocentricity

• ANT-S: Stimulus-Seeking

Alcohol Problems (ALC)

Problematic consequences of alcohol use

Questions are obvious, denial can easily suppress scale

• < 59T little to moderate alcohol use, few adverse consequences related to drinking

• 60T - 69T may drink regularly and have experienced some adverse consequences of drinking

• ≥ 70T alcohol abuse; sig. difficulties due to drinking likely

• ≥ 84T alcohol dependence; unable to cut down on drinking

• ≥ 98T extreme degree of alcohol dependence

Drug Problems (DRG)

Problematic consequences of drug use

• ≤ 59T a person who uses infrequently or not at all

• 60T - 69T may use drugs on a fairly regular basis, and may experience some adverse consequences as a result

• ≥ 70T likely to meet criteria for drug abuse

• ≥ 80T drug dependence

• ≥ 96T extreme drug dependence