A crisis in college student mental health? Self-ratings of psychopathology before and after the COVID-19 pandemic.

The impact of the COVID-19 pandemic on the mental health of college students was investigated in a cross-sectional design using the Personality Assessment Inventory (PAI; Morey, 1991, 2007). Three large samples of college students were recruited for research purposes and given standard instructions: 825 students from two universities assessed in the 2021-2022 academic year (postpandemic), 558 students from three universities assessed between 2016 and 2019 (prepandemic), and 1,051 students from seven universities assessed in 1989 and 1990 (college norms). Comparisons of PAI scores with the prepandemic cohort revealed several significantly higher scores in the postpandemic cohort, especially for scales related to anxiety and depression. Comparisons with the college norms revealed significantly higher scores on several PAI scales in the prepandemic cohort, and these differences were largest for scales related to anxiety, depression, and somatic symptoms. PAI scales related to impulsivity, alcohol use, and other behavior problems showed no changes or decline from earlier to later cohorts. Taken together, the findings suggest that the COVID-19 pandemic has amplified problems with anxiety and depression that existed before the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Construction of item-level scales from the Personality Assessment Inventory to assess levels of personality functioning.

The fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5; American Psychiatric Association, 2013) introduced the clinician-rated Levels of Personality Functioning Scale (LPFS) as an indicator of general personality functioning based on four elements: Identity, Self-Direction, Empathy, and Intimacy. Construct validation strategies were employed to select and evaluate items from the Personality Assessment Inventory (PAI; Morey, 2007) to measure the four elements of the LPFS. In Study 1, conceptual ratings of PAI items produced lists of candidate items for the four elements. In Study 2, a sample of student respondents (n = 312) was used to select the final items for the PAI-Levels of Personality Functioning (PAI-LPF). In Study 3, a large sample of adults (n = 505) gathered using Amazon's Mechanical Turk was used to cross-validate the psychometric properties of the PAI-LPF element scales. Means, standard deviations, and coefficient alpha values are reported for the PAI-LPF total score and element scales using the PAI community adult and clinical patient normative samples. The PAI-LPF offers clinicians and researchers the ability to include the LPFS as part of a comprehensive assessment of personality and psychopathology offered by the PAI. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Stimulus Characteristics in Picture Story Exercise Cards and Their Effects on the Social Cognition and Object Relations Scale-Global Rating Method.

This study examined the effects of stimulus characteristics from the Picture Story Exercise (PSE; Smith, 1992) on the quality of social cognition and object relational functions as expressed in narrative responses. A nonclinical sample of 140 adults told stories to five PSE cards. Three trained raters scored the narratives using the Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Stein & Slavin-Mulford, 2018). Data were then analyzed to determine the extent to which different PSE cards elicited more pathological or more adaptive ratings on the 8 SCORS-G dimensions. Results showed that different cards produced reliable and significant differences in ratings on different SCORS-G dimensions. These results extend findings of previous research (Siefert et al., 2016; Stein et al., 2014) that used the SCORS-G with Thematic Apperception Test (Murray, 1943) cards to a unique and previously unexplored stimulus set. The implications of these findings on the use and interpretation of the PSE and SCORS-G are discussed.

Further Validation of the Response Inconsistency Scale for the Personality Inventory for DSM-5.

Assessment of protocol validity is essential for structured personality tests used in clinical decision making. Measures of inconsistent responding allow researchers and clinicians to identify random or careless response patterns that compromise an accurate interpretation of test results. Keeley and colleagues (2016) developed an Inconsistency scale (INC) for the widely used Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol. 2012. Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42(9), 1879-1890.). The INC produced highly promising results in initial validation studies, and the current study provides a series of additional tests of the adaptability of the INC item pairs across different populations, translations, and versions of the PID-5. Study 1 examines the diagnostic utility of a shortened version of the original INC scale (INC-S) that can be used with the 100-item version of the PID-5; optimum cut scores are identified for this short form adaptation. Study 2 cross-validates the INC-S and compares diagnostic utility to the INC in a sample that completed the full PID-5. Study 3 examines the diagnostic utility of the INC and INC-S using a German translation of the PID-5 with undergraduates and clinical patients. Overall, these validation studies provide robust support for the INC and INC-S scales to discriminate random-generated versus real PID-5 protocols.

Borderline personality disorder diagnosis in a new key.

BACKGROUND: Conceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD). METHOD: Raters of varied professional backgrounds possessing substantial knowledge of PDs (N = 20) characterized BPD criteria with the four domains of the Level of Personality Functioning Scale (LPFS) and 25 pathological personality trait facets. Mean AMPD values of each BPD criterion were used to support a nosological cross-walk of the individual BPD criteria and study various combinations of BPD criteria in their AMPD translation. The grand mean AMPD profile generated from the experts was compared to published BPD prototypes that used AMPD trait ratings and the DSM-5-III hybrid categorical-dimensional algorithm for BPD. Divergent comparisons with DSM-5-III algorithms for other PDs and other published PD prototypes were also examined. RESULTS: Inter-rater reliability analyses showed generally robust agreement. The AMPD profile for BPD criteria rated by individual BPD criteria was not isomorphic with whole-person ratings of BPD, although they were highly correlated. Various AMPD profiles for BPD were generated from theoretically relevant but differing configurations of BPD criteria. These AMPD profiles were highly correlated and showed meaningful divergence from non-BPD DSM-5-III algorithms and other PD prototypes. CONCLUSIONS: Results show that traditional DSM BPD diagnosis reflects a common core of PD severity, largely composed of LPFS and the pathological traits of anxiousness, depressively, emotional lability, and impulsivity. Results confirm the traditional DSM criterion-based BPD diagnosis can be reliably cross-walked with the full AMPD scheme, and both approaches share substantial construct overlap. This relative equivalence suggests the vast clinical and research literatures associated with BPD may be brought forward with DSM-5-III diagnosis of BPD.

Personality traits and dysfunctional construal of online health promotion messages.

PURPOSE: With the Internet becoming increasingly popular as a source of information, blogs offering healthy lifestyle techniques and knowledge have become popular and accessible. Despite their focus on health, these blogs portray content that may be negatively construed by viewers, especially those with or at risk for eating disorders. The present study investigated changes in affect and self-esteem after viewing a prototypic health blog. Personality traits, specifically neuroticism and conscientiousness, were also investigated. METHODS: A prototypic health blog was constructed after extensive review of existing blogs. A parallel format was then followed to create a home décor website for a control condition. Female undergraduate students were randomly assigned to one of two blog sites, and participants completed an earlier personality assessment and post-viewing study questionnaires. RESULTS: Contrary to the hypothesis that readers of the health blog will report more negative outcomes, no main effect of blog condition was found. However, individuals high in trait neuroticism experienced greater differences in negative affect, but not self-esteem, when viewing the health blog versus the control blog. CONCLUSIONS: This study found that viewing health blogs did not have immediate effects on affect and self-esteem, but more neurotic individuals were more inclined to experience negative affect when viewing health promotion messages. Personality traits assessed prior to the experiment were more predictive of negative affect and self-esteem during the experiment than blog viewing conditions. No level of evidence, experimental study.

Prediction of psychotherapy process and outcome with the Personality Assessment Inventory.

The Personality Assessment Inventory (PAI; Morey, 1991) contains scales that were designed to make predictions about how an individual might respond to treatment, thereby allowing clinicians to attune treatment plans to a client's specific needs. The present study utilized two features of the PAI as predictors of treatment process and outcome in a sample of 47 outpatient veterans: the Treatment Rejection (RXR) scale and the Treatment Process Index (TPI). Data were collected for three treatment process and outcome measures: treatment utilization (ratio of appointments attended to appointments scheduled), therapist-rated therapeutic alliance, and symptom change over time. Results indicated that RXR significantly predicted utilization over and above the TPI. The TPI significantly predicted the rate of distress symptom decline over time, but RXR did not. Lastly, neither RXR nor the TPI were significant predictors of therapist-rated alliance.

Personality Constructs and Paradigms in the Alternative DSM-5 Model of Personality Disorder.

The DSM-5 Section III alternative model for personality disorders (AMPD) is a personality disorder (PD) nosology based on severity of personality dysfunction and pathological traits. We examined the degree to which the personality constructs identified by McAdams and Pals (2006; dispositional traits, characteristic adaptations, narrative identity) and the paradigms of personality assessment described by Wiggins (2003; psychodynamic, interpersonal, personological, multivariate, empirical) are represented within the AMPD. Nine raters expert with the AMPD and personality evaluated elements of Criterion A and the 25 trait facets of Criterion B for presence of type and degree of personality constructs and paradigms, as well as level of inference. Criterion B showed higher rater agreement compared to Criterion A. Criteria A and B reflect different configurations of construct, paradigm, and level of inference. The characteristic adaptation construct and interpersonal paradigm were strongly reflected in both Criteria A and B. The psychodynamic and personological paradigms and the narrative identity construct were highly correlated, and the multivariate, empirical, and dispositional traits variables were highly correlated. Results illustrate differential conceptual emphases as well as areas of overlap with Criteria A and B. This characterization highlights that PD nosology rests on personality theory and suggests implications for integrative PD assessment.

Evaluating Circumplex Structure in the Interpersonal Scales for the NEO-PI-3.

Scales to assess the eight octants and two axes of the interpersonal circumplex (IPC) using items from the revised NEO Personality Inventory were introduced by Traupman et al. Item changes in the revised and renormed third edition of the NEO instrument (NEO-PI-3) have affected item content in all eight octant scales, underscoring the need to reexamine the IPC scales. The current study examines the circumplex structure of the revised octant scales in the NEO-PI-3 and their correlations with the Dominance and Warmth scales of the Personality Assessment Inventory in 568 undergraduate students. The data show perfect fit to circumplex structure, suggesting equivalent or better assessment of the IPC with the NEO-PI-3 octant scales. Convergence of the eight octants with the Personality Assessment Inventory interpersonal scales further supports their saturation with interpersonal content and appropriate location within the IPC.

On Being the Same in Different Places: Evaluating Frame-of-Reference Effects Across Two Social Contexts.

Frame-of-reference (FOR) effects in personality assessment are demonstrated when self-rated items oriented to specific contexts (e.g., workplace) show better predictive validity than noncontextualized items. Empirical support of FOR effects typically relies on job performance ratings or academic grades for criteria. The current study evaluates FOR effects using ratings of personality provided by informants from the home or school context. Items from the NEO Five-Factor Inventory (NEO-FFI; Costa & McCrae, 1992) were contextualized to the home and school contexts to create NEO-Home and NEO-School versions. One hundred fifty-eight college students completed the NEO-Home and NEO-School questionnaires, and 161 college students completed the standard, noncontextualized NEO-FFI. All participants recruited one peer from college and at least one parent to complete standard rater versions of the NEO-FFI. Contextualized self-ratings did not show FOR effects. NEO-Home self-ratings did not correlate higher with parent ratings than with peer ratings, and NEO-School self-ratings did not correlate higher with peer ratings than with parent ratings. Standard NEO-FFI self-ratings generally showed higher self-informant agreement with both types of informants than contextualized self-ratings. The pattern of correlations suggests that validity is enhanced more by specific trait-informant combinations than by the contextualization of items to social contexts.

The effectiveness of clinician feedback in the treatment of depression in the community mental health system.

OBJECTIVE: We describe the development and evaluation of a clinician feedback intervention for use in community mental health settings. The Community Clinician Feedback System (CCFS) was developed in collaboration with a community partner to meet the needs of providers working in such community settings. METHOD: The CCFS consists of weekly performance feedback to clinicians, as well as a clinical feedback report that assists clinicians with patients who are not progressing as expected. Patients in the randomized sample (N = 100) were predominantly female African Americans, with a mean age of 39 years. RESULTS: Satisfaction ratings of the CCFS indicate that the system was widely accepted by clinicians and patients. A hierarchical linear models (HLM) analysis comparing rates of change across conditions controlling for baseline gender, age, and racial group indicated a moderate effect in favor of the feedback condition for symptom improvement, t(94) = 2.41, p = .017, d = .50. Thirty-six percent of feedback patients compared with only 13% of patients in the no-feedback condition demonstrated clinically significant change across treatment, χ2(1) = 6.13, p = .013. CONCLUSIONS: These results indicate that our CCFS is acceptable to providers and patients of mental health services and has the potential to improve the effectiveness of services for clinically meaningful depression in the community mental health setting.

The validity of a regression-based procedure for detecting concealed psychopathology in structured personality assessment.

Positive Impression Management (PIM) predicted scoring of the Personality Assessment Inventory (PAI; Morey, 2007) is a regression-based procedure designed to inform diagnostic hypotheses when respondents engage in positive response distortion (PRD). Observed scores that deviate above the PIM-predicted score are proposed to indicate areas of true psychopathology that are being concealed by the respondent. To test this proposition, the PAI was administered twice to 334 undergraduate students, using standard instructions and job applicant role-play instructions. For most PAI scales and subscales, the PIM-predicted deviation scores from the role-play condition were significantly correlated with scores on the corresponding scale obtained from the standard administration condition. Exceptions to the general findings are noted for some scales, and recommendations are offered for further research and clinical application of PIM-predicted scores.

Four factors of impulsivity differentiate antisocial and borderline personality disorders.

Impulsivity is a shared criterion for the diagnosis of antisocial and borderline personality disorders, and this link may account for the high comorbidity rates between the two disorders. The current study aimed to differentiate between borderline and antisocial personality disorders using the four factors of impulsivity identified by Whiteside and Lynam (2001). Five hundred thirty-six undergraduate participants completed the personality assessment inventory (PAI; Morey, 1991) to assess borderline and antisocial personality features and the NEO personality inventory, third edition (NEO-PI-3; McCrae & Costa, 2010) to assess the four factors of impulsivity. Results indicate that negative urgency and lack of perseverance were significantly and uniquely related to borderline features, while sensation seeking and lack of premeditation were significantly and uniquely related to antisocial features. The implications of these results for improved differential diagnosis are discussed.

Prospective prediction of college adjustment using self- and informant-rated personality traits.

Studies that relate normal personality traits to students' adjustment to college have relied heavily on self-rating methods, concurrent designs, and academic performance indicators as criteria. We conducted a prospective study of high school seniors with a follow-up assessment made near the end of their freshman year of college. Self-ratings of personality traits and college adjustment were obtained from 90 students using the revised NEO personality inventory (NEO PI-R; Costa & McCrae, 1992) and the student adaptation to college questionnaire (SACQ; Baker & Siryk, 1989 ). Ratings of personality were also obtained from parents (n = 66) and same-sex peers from the college setting (n = 78) using the NEO five-factor inventory (NEO-FFI; Costa & McCrae, 1992 ). SACQ academic adjustment was correlated with conscientiousness ratings by all three sources and with openness ratings by parents and peers. SACQ Social Adjustment was correlated with self-ratings of neuroticism and peer ratings of extraversion. SACQ personal-emotional adjustment was correlated with self-ratings and parent ratings of neuroticism. Ratings by parents and peers showed significant incremental validity over self-ratings in the prediction of certain trait-adjustment relationships.

Personality assessment screener in a primary care sample of low-income urban women.

The diagnostic efficiency of the Personality Assessment Screener (PAS; Morey, 1997) total score was evaluated using selected scales from the Patient Health Questionnaire (Spitzer, Kroenke, & Williams, 1999), the fourth edition of the Personality Diagnostic Questionnaire (Hyler, 1994), and the Alcohol Use Disorders Identification Test (Saunders, Aasland, Babor, DeLaFuente, & Grant, 1993) as reference standards. Complete data were collected from 110 women seeking treatment at an urban family medicine training clinic. Total PAS scores were effective in identifying patients with mood disorders, cluster B personality disorders, and alcohol use disorders, but the optimum cut scores were higher than the cut score of 19 recommended by Morey (1997). The 10 PAS element scores showed good convergent and discriminant correlations with the reference measures. These findings support the utility of the PAS to screen for major forms of psychopathology in an urban primary care setting.

Internal consistency, retest reliability, and their implications for personality scale validity.

The authors examined data (N = 34,108) on the differential reliability and validity of facet scales from the NEO Inventories. They evaluated the extent to which (a) psychometric properties of facet scales are generalizable across ages, cultures, and methods of measurement, and, (b) validity criteria are associated with different forms of reliability. Composite estimates of facet scale stability, heritability, and cross-observer validity were broadly generalizable. Two estimates of retest reliability were independent predictors of the three validity criteria; none of three estimates of internal consistency was. Available evidence suggests the same pattern of results for other personality inventories. Internal consistency of scales can be useful as a check on data quality but appears to be of limited utility for evaluating the potential validity of developed scales, and it should not be used as a substitute for retest reliability. Further research on the nature and determinants of retest reliability is needed.

Validity of the PAI interpersonal scales for measuring the dimensions of the interpersonal circumplex.

Two studies evaluated the validity of the interpersonal scales, Dominance (DOM) and Warmth (WRM), from the Personality Assessment Inventory (PAI; Morey, 1991, 2007) to measure the 2 dimensions of the interpersonal circumplex (IPC). In Study 1, 114 college freshmen completed the PAI and the Interpersonal Adjectives Scale (IAS; Wiggins, 1995). In Study 2, 170 college students completed the PAI and the Inventory of Interpersonal Problems-Short Circumplex (IIP-SC; Soldz, Budman, Demby, & Merry, 1995). The results of both studies supported the convergent validity of DOM and WRM, although discriminant validity was stronger using the IIP-SC as the criterion. Circumplex projections placed DOM and WRM in the appropriate segments of both the IAS and IIP-SC. These findings provide additional support for the validity of the PAI interpersonal scales as measures of the primary dimensions of the IPC.

Are implicit motives "visible" to well-acquainted others?

In this study, we compared self-ratings and informant ratings of personality as predictors of implicit motives, need for achievement (nAch), and need for affiliation (nAff). A total of 120 participants wrote creative stories to 5 images from the Picture Story Exercise (Smith, 1992) and completed the Revised NEO Personality Inventory (Costa & McCrae, 1992). Three well-acquainted informants rated each participant's personality with the Big Five Inventory (John & Srivastava, 1999) and Saucier's (1994) Mini-Markers. Consistent with the study hypotheses, peer ratings of Conscientiousness significantly predicted nAch scores after controlling for word count and self-rated Conscientiousness. Contrary to hypotheses, peer ratings and self-ratings in all 5 domains did not significantly predict nAff scores. The findings are considered in the interest of bridging the gap between trait and motive concepts in personality assessment.

Development and initial validation of a multi-domain self-report measure of work functioning.

The need for a self-report measure of work functioning that is flexible to involvement in work across 3 domains (employment, school, and home) led to the development of the Work History Inventory (WHI). The WHI was administered to 185 patients who participated in psychotherapy studies and to 110 community control respondents who were not in treatment. The WHI Total score and subscales (Performance and Interpersonal) demonstrated adequate to good reliability. WHI scores correlated moderately with symptom measures and strongly with another work functioning measure. Changes across treatment indicated that the WHI Total and Performance scores increased significantly across psychotherapy. The WHI seems to be a reliable and valid instrument for measuring treatment related changes in work functioning.