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May is Mental Health Awareness Month. Mental health providers play a critical role in promoting awareness and working to improve the lives of others. Yet, compassion fatigue and burnout are very real issues for those in the field. For the next two weeks, the PAR blog will explore these issues within the mental health community and provide guidance on how those in the mental health field can prioritize self-care to protect their own mental health needs.

Mental health providers with prolonged or cumulative exposure to compassion stress may be vulnerable to burnout if early steps to counteract excessive empathetic involvement are not taken.

A major part of a mental health professional’s job is the ability to empathize with clients. Developing a successful therapeutic alliance leads to better outcomes and correlates with the capacity to identify, comprehend, and share an individual's feelings, thoughts, and experiences. However, prolonged exposure to distressing information can negatively affect a mental health professional and is a risk factor for secondary traumatic stress.

Studies have shown that health professionals have moderate to high levels of burnout and secondary traumatic stress, but few present the prevalence of compassion fatigue and burnout found among mental health professionals.

Past studies have reported that people who work in helping professions have prevalence rates of compassion fatigue ranging from 7.3% to 40% and estimate that 21% to 61% of mental health practitioners experience signs of burnout.

According to an APA survey, the number of psychologists who said they could not keep up with patient demand increased from 30% in 2020 to 41% in 2021 to 46% in 2022. Similar amounts were recorded in 2020 (41%) and 2021 (48%), with nearly half (45%) of respondents in 2022 reporting feeling burned out.

Compassion stress

Secondary traumatic stress (compassion stress) negatively impacts mental health and can lead to psychological issues such as strained relationships, insomnia, poor sleep hygiene, severe depressive disorder, and compassion fatigue. Mental health providers with prolonged or cumulative exposure to compassion stress may be vulnerable to burnout if early steps to counteract excessive empathetic involvement are not taken.

Compassion fatigue

Compassion fatigue is caused by extended exposure to traumatized individuals. Mental health providers belong to a profession that demands constant empathy. While empathy is essential to your work, persistent and excessive demands for empathy can become emotionally exhausting and depleting without adequate time to recharge.

Signs and symptoms of compassion fatigue

Compassion fatigue stems from exposure to vicarious trauma and can affect people differently, but common signs to watch for include the following:

•            Chronic emotional and physical exhaustion

•            Anger or irritability

•            Headaches

•            Weight loss

•            Increased anxiety or irrational fears

•            Issues with intimacy

•            Decreased sympathy and/or empathy toward patients or coworkers

•            Dread in working with certain patients

•            Negative feelings separate from the work environment about work, life, or others

•            Negative coping behaviors, like alcohol and drug use

•            Increased absenteeism

•            Feelings of inequity and pessimism

•            Self-contempt

•            Low job satisfaction

Sometimes compassion fatigue and burnout are used interchangeably. There is a distinction. The onset of compassion fatigue is more abrupt, whereas burnout develops gradually over time. 

Burnout

The World Health Organization (WHO) defines burnout as a “syndrome conceptualized as resulting from chronic workplace stress that has not been fully managed.” The WHO's definition of burnout distinguishes that “burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

Symptoms of burnout

There are three key signs of burnout, which include:

•            Exhaustion: Individuals often feel emotionally exhausted or drained, unable to cope, and have low moods and energy. They may also experience physical symptoms such as GI problems.

•            Loss of interest in work-related activities: Individuals often feel increasingly frustrated and stressed by their jobs. They may experience growing cynicism about their work environment or colleagues and emotionally withdraw and feel numb regarding their work.

•            Decreased effectiveness or performance: Burnout affects daily tasks at work or home, and individuals are often very pessimistic, have difficulty concentrating, lack creativity, and lack energy and enthusiasm.

Factors that may lead to  burnout

Mental health professionals work with patients with mild to severe depression, anxiety, trauma, abuse, neglect, addiction, and other mental health illnesses, all of which can take an emotional, mental, and psychological toll on providers. Aside from the psychosocial issues, Patel and colleagues divide the contributing factors for provider burnout into workplace, organizational, and personal characteristics.

Workplace factors

There are many factors related to the workplace, such as excessive workloads, increased stress levels in overworked providers, the need to keep meticulous records, and time-consuming clerical duties. One national survey found that each hour spent interacting with patients added 1-2 hours of additional work with no additional compensation. Long work hours, lack of downtime at night or during the weekend, and the need to bring work home instead of taking time for themselves are also factors in burnout.

Organizational factors

Organizational factors include negative leadership behaviors, little to no reward or room for advancement, poor social support, and lack of interpersonal collaboration.

Personal characteristics

Personal characteristics include self-criticism, unhealthy coping strategies, perfectionism, poor work-life balance, poor sleep habits or lack of sleep, and inadequate support systems outside of work may also contribute to burnout. Studies have also shown that new and younger health providers have twice as much stress as older colleagues. Age and gender may impact levels of burnout, and studies have shown that younger workers and women may be at higher risk for burnout.

The impact of burnout

There are many downstream effects that burnout causes, such as:

•            Providers are at increased risk for developing cardiovascular disease, depression, or substance dependence.

•            Providers who lose their empathy could invite secondary harm to patients.

•            Increased healthcare costs are more common when providers suffer from burnout.

•            Compassion fatigue may lead to decreased retention and increased turnover and may lead some mental health professionals to leave the field.

Though empathy is the cornerstone of a strong connection and ability to treat and improve the mental health of their patients, mental health professionals must remember to prioritize their own physical and mental health. For health professionals to give their patients the best care possible and enhance client's quality of life, taking time off from work is essential to unplug, decompress, and practice self-care.

Come back next week to learn self-care tips meant specifically for those in the mental health field.

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This past weekend, PAR staff celebrated the 45th anniversary of the founding of this company. In honor of our anniversary, we thought we would share some fun facts about PAR.

  • It all started on a table—Bob and Cathy Smith began PAR on wooden table in their home in 1978. That table now holds a special place of honor in the PAR offices.
  • PAR employees are active in supporting our community organizations. We currently donate time and financial support to more than 70 charitable organizations each year.
  • Our Distribution Center ships orders with an incredible 99.99% accuracy rate—and it’s even more unbelievable because orders are shipped the day they are placed.
  • PAR is proud to have a staff that is 60% women.
  • Each year, PAR participates in a companywide fundraiser for United Way. We had 100% staff participation this year and raised $113,278 in staff contributions for this worthy organization.
  • Each week, a rotating group of PAR employees take part in a Meals on Wheels route, delivering fresh, nutritious meals to homebound individuals in our community.
  • We always say, “Customer service is our most important product,” and that’s not just an empty slogan. Our Customer Support team has more than 130 years of combined PAR experience and go through intensive training so they can be sure you are completely satisfied when you call. Also, all calls are answered by a live person—no automated messages!

These are just a few of the things we are proudest of as we look back on our 45-year history. As we look to the future, we hope to continue creating connections and changing lives with the work we do here at PAR.

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Each May, Mental Health Awareness Month seeks to raise awareness about the importance of mental health and reduce the stigma surrounding mental health disorders. Throughout the year, but especially in May, mental health providers play a crucial role in promoting awareness and taking action to improve the mental health of our communities.

What is Mental Health Awareness Month?

Mental Health Awareness Month began in the United States in 1949 as Mental Health Week. It was expanded to a month-long observance in 1980. The goal of Mental Health Awareness Month is to raise awareness about mental health and wellness, reduce the stigma surrounding mental health conditions, and promote greater access to mental health services and resources.

Why is Mental Health Awareness Month important?

In the U.S., more than 1 in 5 adults are living with a mental illness. Yet despite the prevalence of mental illness, stigma and discrimination surrounding mental health are significant barriers to treatment and recovery. Mental health and physical health are equal components to a healthy lifestyle, but many individuals fail to receive the support and care they need.

Mental Health Awareness Month provides an opportunity to break down these barriers and raise awareness about the importance of mental health. By promoting understanding and acceptance, we can encourage individuals to seek help, normalize the conversation around mental health, and improve access to mental health services and resources.

What can mental health professionals do to get involved?

As mental health professionals, we have a critical role to play in promoting mental health awareness and reducing stigma. Here are some ways we can get involved:

Raise awareness: Use your platform and expertise to educate others about mental health and wellness. Share information about Mental Health Awareness Month on social media and within your professional networks. Write blog posts, create infographics, and share resources that promote mental health awareness.

Engage with your community: Connect with local organizations and community groups to promote mental health awareness. Offer to speak at events or host workshops on mental health and wellness. Collaborate with other mental health professionals and organizations to create events and initiatives that promote mental health awareness and reduce stigma.

Advocate for policy change: Mental health professionals can also get involved in advocacy efforts to improve mental health policies and access to care. Contact your elected officials to express your support for mental health legislation and advocate for increased funding for mental health services and research.

Practice self-care: Mental health professionals also need to take care of their own mental health and well-being. Practicing self-care is essential to preventing burnout and maintaining mental health. Take breaks when needed, engage in regular exercise and meditation, and seek support.

No matter how you choose to get involved, Mental Health Awareness Month provides an important opportunity for mental health professionals to promote awareness and reduce stigma surrounding mental health, advocating for policy change, and providing direct services and support.

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During our recent PARtalks webinar series on assessing individuals with disabilities, PAR received many questions about where to go for further resources. Here is a short list of additional resources that may be helpful when assessing people with various disabilities.

American Psychological Association (APA)

APA offers a significant number of resources on disability issues. In addition to Guidelines for Assessment and Intervention with Persons with Disabilities, APA also offers disability-specific APA resolutions, and a disability mentoring program designed to support individuals with disabilities who are psychologists or who want to be. APA offers resources on accessibility, inclusive language, and the Americans with Disabilities Act, and more.

Association of University Centers on Disabilities (AUCD)

The AUCD is a network of university centers that provide resources and training on disability issues, as well as advancing policy and practice for and with individuals with developmental and other disabilities. The AUCD offers a library of materials and resources on disability rights, disability research, and disability policy.

Disability.gov

Disability.gov is a federal government website run by the Department of Labor that provides information and resources on disability-related issues related to disability rights, employment, education, and health.

Disability Rights Education & Defense Fund (DREDF)

The DREDF is a national disability rights law and policy center that provides information and resources on disability issues. They are a leading national civil rights law and policy center directed by individuals with disabilities and parents who have children with disabilities. They offer insight and guidance on special education, healthcare access, and additional public policy and legal issues.

National Association of School Psychologists (NASP)

NASP offers advice and guidance on modifying assessments as well as evaluating the effectiveness of those interventions.

National Center on Disability and Journalism (NCDJ)

The NCDJ is a great resource for mental health professionals. Although the NCDJ is designed to provide resources and training for journalists on disability issues, everyone can learn quite a bit from their Disability Language Style Guide. The style guide offers insight on language. It is offered in both English and Spanish.

National Joint Committee on Learning Disabilities (NJCLD)

The NJCLD is committed to the education and welfare of individuals with learning disabilities. The NJCLD offers resources and supports for individuals with a variety of learning disabilities. The NJCLD offers insight into assessment and intervention.

PAR resources

In addition to a recent blog on modifications versus accommodations, PAR offers a variety of on-demand videos on a variety of topics on the PAR Training Portal.

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One of PAR’s core values is to give back to the community. We participate in many special events during the year that benefit organizations in the Tampa Bay area. Here’s a look at some of the activities and events PAR staff have participated in recently.  

In January, PAR staff partnered with Feeding Tampa Bay to support their Mega-Pantry program. This program is held several times per week in various locations around Tampa. The Mega-Pantry distributes fresh fruits and vegetables, bread, dry goods, and more in a drive-through-style event to those in our community who are experiencing food insecurity. PAR staff members sorted food and loaded hundreds of cars with enough food to feed each family for a week.  

A yearly favorite event is Bark in the Park. PAR staff (and some of our furry friends) participated in a walk that set a PAR fundraising record—raising $12,325 to benefit the Humane Society of Tampa Bay. This year’s event was able to raise more than $180,000 to help animals. 

Later in February, a team from PAR participated in picking up litter as part of our regular Adopt-A-Road clean up. We were able to collect trash and recyclables, cleaning up the area that surrounds the PAR campus. 

We have also hosted the Big Red Bus from OneBlood every 8 weeks in the PAR parking lot. Every 2 seconds, someone in the U.S. needs blood. Generous blood donors are the only source of blood for patients in need of a blood transfusion. The PAR team is always willing to roll up our sleeves to help those in need. 

 

We are so grateful to be able to give back to our community with our time, energy, and resources. To learn more about what we are doing to make a difference in the Tampa Bay area, visit our Community PARtners page. 

 

 

 

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During our recent PARtalks webinar series on assessing individuals with disabilities, PAR received some questions about adapting, modifying, and accommodating assessments. It is important to be mindful of a range of psychometric, social, clinical, and disability-related issues. We hope the following will provide helpful guidance when determining if modifications or accommodations are necessary.

Considerations when assessing individuals with disabilities

There are many issues to consider that may complicate the psychological testing of people with disabilities. It is important to attend to issues of bias, reliability, and validity.

Language,  motor, sensory, medical, and cognitive disabilities can impact aspects of an assessment. Additionally, comorbid conditions or secondary disabilities can be a complicating factor.

It is crucial for examiners to consider each individual's disability and how it relates to other functions to develop a strategy that ensures the appropriate construct is being measured. For example, disability-related symptoms such as fatigue and pain can confound psychometric tests and artificially inflate measures of depression. Or a motor-functioning disability that affects fine motor control may create results that mistakenly imply cognitive impairment. Examiners who do not take these issues into consideration risk drawing misleading inferences, making inaccurate conclusions, and offering unsuitable treatment recommendations.

How do you determine an assessment is suitable for a particular individual?

To determine if an instrument is suitable for use with a client with a disability, clinicians must evaluate if the measure(s) being considered are appropriate for use without introducing accessibility challenges. If the construct to be measured will be measured in a way that requires a specific functional ability that is related to the client’s disability, or if the measure’s administration instructions and response options are related to the client’s impairment, for example, another measure may be considered.   

The clinician should consider validity information regarding a measure’s use with people with specific disabilities, just as they would for any other population. Quantitative measures should be supplemented by qualitative and functional assessments. Before testing, it is important to meet with the client to understand disability-specific characteristics related to the constructs of interest. It is the clinician's responsibility to describe the assessment and subsequent results in terms that the client can easily understand.

When is it suitable to alter an assessment?

Any decisions to modify protocols requires thoughtful consideration and justification but may be useful ways to support individuals with disabilities. There are two types of alterations to testing, accommodations and modifications. Accommodations improve access to the test without affecting the construct being measured. Modifications may affect the construct and may influence validity.

  • Accommodations: A testing accommodation is a change in test format, presentation, administration, or response procedures. Accommodations do not alter the construct being measured and scores are comparable with the original test.

  • Modifications: Modifications are testing changes that may alter the intended construct. The purpose of a modification is to improve accessibility while retaining as much of the original construct as possible.

 Examples of accommodations and modifications

Accessibility means the ability to access, interact with, and respond appropriately to test content. It involves designing a measure in a way that reduces barriers to a valid assessment of a given construct. Accommodations and modifications are often made to increase accessibility, but if accessibility is designed into the structure of an instrument, they may not be required.

Determining the necessity of an accommodation depends on how the disability presents as well as the construct or constructs being assessed. Accommodations help clients with varying levels of ability by removing access barriers that might influence the individual’s results. However, accommodations do not alter the construct being measured.

Accommodations may be made to the environment or to the way a task is presented without changing the content of the task. An accommodation for a student with a visual impairment might be  enlarging print materials; an accommodation for a student who is deaf might be providing an ASL interpreter.

Modifications, however, can be changes that are made to the content or expectations of an assignment, task, or assessment. A student with a learning disability might receive a modification that reduces the number of questions on a test or provides untimed access to the materials. Modifications change what the individual is expected to learn or do in order to make it more accessible.

In general, modifications are more significant changes. Modifications alter what is expected of the individual; accommodations are less significant changes that provide support for the individual to access the same content and activities as their peers.

Resources on accommodations and modifications

Learn more about modifying psychological assessments for individuals with disabilities:

American Psychological Association (APA) Guidelines for Assessment and Intervention with Persons with Disabilities: APA has developed these guidelines to help psychologists develop and implement effective, fair, and ethical psychological assessments and interventions.

National Joint Committee on Learning Disabilities (NJCLD): The NJCLD has developed guidelines for the assessment of individuals with learning disabilities. The NJCLD offers recommendations for modifying psychological assessments.

National Association of School Psychologists (NASP): NASP offers advice and guidance on modifying assessments as well as evaluating the effectiveness of those interventions.

The PAR Training Portal. Catch up on the PARtalks disability series on the PAR Training Portal. Recorded webinars are available on demand to help you learn more about working with individuals with a variety of disabilities.

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This week’s blog was contributed by Nikel Rogers-Wood, PhD, LP, HSP. Dr. Rogers-Wood is a licensed psychologist and a project director at PAR. She has a PhD in counseling psychology.

“I’ve been feeling really anxious, my heart races, and I can’t concentrate. I already know I have generalized anxiety disorder because I watched a bunch of TikToks and took a quiz online that came back with a diagnosis.” 

Sound familiar? Social media, particularly TikTok, is a place where clients and potential clients sometimes go to find answers to their mental health questions. Though it's encouraging to see more social acceptance and support for mental health challenges, there are so many influencers out there that it can be difficult to know who has professional expertise and what information is accurate. 

Further complicating the situation are online quizzes. Type “Do I have depression?” into Google and get pages of results. Many of these quizzes also show up as ads and links embedded in social media feeds. What differentiates these free social media quizzes from well-researched and empirically validated tests? A great deal. Can the general public tell the difference? Not yet. That’s where PAR can help.

As one of our assessment customers, you already know the value of an accurate evaluation. After all, quality assessment results in accurate diagnosis, which drives effective treatment and positive client outcomes. That’s why it’s so important for clients to seek testing and support from qualified professionals. So how do you help someone who has self-diagnosed find their way to more accurate and helpful information?    

Why validity and reliability matter

The first step is to validate what they’re seeking—answers. Something is happening in their lives that has driven them to find the answer on the internet. However, much like it's hard to find the right street when your GPS is programmed to another part of the country, it’s hard to find answers when you take a quiz that isn’t reliable or valid.

It’s important to educate our communities so they realize that building a good assessment measure goes beyond choosing questions to ask. They need to know that researchers and test publishers devote time and energy into determining whether individual items (and the test as a whole) measure what they are supposed to measure; if there are differences in outcomes based on demographic factors like age, sex, and race/ethnicity; if the results can be trusted to be reliable; and how the results fit in with diagnoses. Although it may be tempting to take a free quiz that pops up on our social media feed, when it comes to our mental health, wouldn’t it be better to find a resource that will give us accurate results?

PAR provides a wide variety of high-quality assessments that have been well built, validated, and thoroughly researched. We also offer our products in performance-based and self-report formats. For individuals who prefer a self-serve style of assessment, the Self-Directed Search asks questions about career interests and preferences and produces a thorough, client-friendly report with results and guidance on next steps. When a deeper dive is necessary, individuals can collaborate with a licensed professional and use an instrument like the PAI for answers.    

The difference between unvalidated quizzes and validated assessment measures is the difference between cookies and a real meal. Can you eat either one when you’re hungry? Sure. However, the cookies only take the edge off hunger and your nourishment can’t be based on cookies alone. At PAR, we offer the five food groups. Snacks aren’t going anywhere, but when you want to get what you really need, come to us.

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This week’s blog was contributed by Maegan Sady, PhD, ABPP-CN. Maegan is a project director in PAR’s research and development department in addition to being a licensed psychologist and board-certified neuropsychologist. She worked as a pediatric neuropsychologist for nearly a decade before joining PAR.

Add trauma screening to your evaluation checklist

Assessment clinicians are trained to look for hidden problems, and we all know the common ones. If a child comes in with a referral for an ADHD evaluation, we screen for anxiety and sleep problems. When an older adult complains of memory problems, we inquire about symptoms of depression. There’s a new kid on the block, though—trauma. Trauma isn’t new, of course, but more clients may be experiencing its effects along with whatever brought them to you for assessment.

Expanding the definition of trauma

Trauma is a broad term for experiences that are dangerous or threatening. Although abuse or violence quickly come to mind, experiences of losing a loved one, food insecurity, or chronic social isolation can just as readily result in symptoms. The COVID-19 pandemic has increased these experiences, and some argue the pandemic itself may be a form of trauma. The impact of multiple stressful events—say, experiencing displacement due to a wildfire during the pandemic—can be multiplicative. Similarly, existing health and economic disparities have been exacerbated by pandemic-related stressors.

Screening for trauma

Because traumatic experiences have increased, it makes sense that more clients are experiencing trauma effects. Trauma symptoms can mimic other disorders, including anxiety, depression, and even psychosis or personality disorder. Untreated, trauma effects can negatively impact physical health and lead to higher rates of suicide and substance abuse.

To decrease the chance that you miss trauma as a comorbid cause of your client’s problems, make it routine to ask about trauma history. A written checklist (e.g., the Adverse Childhood Experiences Questionnaire) can help clients feel more comfortable disclosing their history. Unless you are specifically trained in trauma-related care, do not ask your client for details, but assure them you will provide resources.

If there is a positive history of trauma, assess for associated symptoms to guide recommendations; structured checklists can identify the severity and breadth. No matter the age of the client, PAR has you covered with the TSCYC, TSCC, TSI-2, FACT, and the DAPS. When time is short, screening versions are also available for most of these measures. And because many digital options are available on PARiConnect, it's easy to add a variety of administrations to your inventory when you need them.

Referring for additional assessment or treatment

When trauma is a contributing factor for your patient, you can provide a referral for evidence-based treatment and/or educational resources. For children, the American Academy of Child and Adolescent Psychiatry and The National Child Traumatic Stress Network have handouts and book recommendations. For adults, visit the National Center for PTSD. For individuals of all ages, see the website for the International Society for Traumatic Stress Studies.

Making trauma screening a routine part of your clinical assessment may uncover important treatment targets, helping your client deal more effectively with their original presenting concerns.

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Each year, International Women’s Day is celebrated on March 8, recognizing the social, economic, cultural, and political achievements of women around the world. The day is also an opportunity to raise awareness of the challenges and inequalities that women face and to advocate for gender equality.

It is no secret that women have historically faced greater barriers than men when it comes to fully  participating in the economy. Disparities between men and women persist in the form of pay gaps, uneven opportunities for advancement, and unbalanced representation in important decision-making. Although women represent 58.4% of the U.S. workforce as of September 2022, women only represent 35% of senior leadership positions. And while 82% of Americans say it’s important that men and women have the same career opportunities, only about a third of Americans say their place of business prioritizes putting women in leadership positions.

Here at PAR, we are proud to have a staff that is 60% women. When we polled our staff to ask about women coworkers whose work deserved to be acknowledged publicly, the response was overwhelming—citing women who inspired them in their day-to-day life, those who were contributing their time and energy to charities and causes, those who had faced personal struggles, and many who had celebrated incredible achievements. We are so proud to work among such women today and every day.

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Recently, PAR added several new features to the PAI Plus reports on PARiConnect. As a result, we have received a few questions about how to use the Negative Impression Management (NIM) and Positive Impression Management (PIM) predicted profile overlays as well as the NIM- and PIM-specific profiles. We went directly to author Leslie C. Morey, PhD, to get his answers on how you can use these features to enhance your understanding.

PAR: What are the NIM and PIM predicted profile overlays?

 LM: NIM and PIM predicted profile overlays are regression-based predictions of the profile based on information from the validity scales. These profiles represent one strategy for understanding the influence of the response styles represented by the validity scales, NIM and PIM. In this approach, PAI scale scores are predicted solely by either NIM or PIM, using a regression model based on the correlations observed in the standardization samples. Thus, these profiles are not based on data from the profile of the individual being assessed, with the exception of their NIM or PIM scores. The resulting profile constitutes what would be expected given the observed score on NIM or PIM. The contrast between observed (i.e., the respondent’s actual PAI profile) and predicted profiles indicates the extent to which scale scores are expected to have been influenced by response set distortion. If the observed and expected scores are comparable (e.g., within one standard error of measurement), then the scores can be largely attributed to the effects of whatever led to the observed response set, such as potential exaggeration or cognitive distortions. 

PAR: What are NIM- and PIM-specific profiles?

LM: The NIM- and PIM-specific profiles represent another strategy for understanding the influence of any observed response styles on the PAI profile. However, instead of predicting every score on the rest of the profiles, it compares the observed profile to a group of profiles from the standardization samples that displayed a similarly elevated score on PIM or NIM. This strategy then calculates standard scores for the individual’s observed scores based on the means and standard deviations of similarly distorted profiles. Thus, elevations indicate psychopathology above and beyond response sets. Unlike the predicted scores, which tend to yield greater variability in predictions for negative impression management than for positive impression management, the specific score strategy is equally useful in understanding the influences of both types of response sets. 

Two groups are used for comparison purposes on the NIM- and PIM-specific scores, as defined by two ranges on these scales. The first group, the lower range, is based on cutoff scores determined to have maximal efficiency in distinguishing impression management from genuine groups. For NIM, this range is 84T to 91T; for PIM, it is 57T to 67T. The second group, the higher range, is equivalent to scores that equal or exceed two standard deviations above the mean in a clinical population: 92T for NIM and 68T for PIM. No specific scores are generated if NIM is less than  84T and PIM is less than 57T.

 

Read more about how the NIM scale can be used to assess malingering. 


 

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