Reliability of the French-Canadian adaptation of the Personality Assessment Inventory: Medical–legal implications

The Personality Assessment Inventory (PAI) is a reliable multidimensional psychometric inventory that is increasingly being used in the medical–legal context. To date, 18 language adaptations of the PAI exist, yet only the Spanish, Greek and German language versions have been examined psychometrically. This study evaluated the psychometric properties of the French-Canadian version of the PAI by comparing mean scale and subscale scores between the French-Canadian and English language versions, and analyzing the internal consistency and mean item inter-correlations (MICs) of each version in a sample of 50 bilingual university students. Cronbach’s alphas ranged from −.57 to .80 in the French-Canadian version and from −1.10 to .83 in the English version, with most scales being below .70, indicating inadequate internal consistency. In addition, most of the MICs were below .20, indicating a lack of item homogeneity. Caution is given to this adaptation of the PAI in the medical–legal context. Key words: bilingual, language adaptation, medical–legal, Personality Assessment Inventory, psychological assessment, psychometrics, reliability

The generalizability of psychological tests with specific populations is an insidious problem in clinical psychology and may have significant implications in the context of a medical–legal examination. For example, if psychologists are asked to objectively substantiate the breadth, severity and veracity of subjective symptomatology and come to a diagnostic opinion, it is essential that such opinions are based on firm scientific grounds in order to meet legal standards and be accepted by the courts. This is especially important since psychologists are asked to suggest/comment on the efficacy of treatment, determine disability benefit or comment on the permanence or seriousness of a psychological injury, all in the ultimate context of assisting the trier of fact in a medical–legal setting. The Standards of Educational and Psychological Testing state that translating a measure into another language does not ensure the construct measured remains comparable to the original test (American Educational Research Association, American Psychological Association & National Council on Measurement in Education, 2014). As such, the examination of language adaptations is an essential part of the study of cultural differences and similarities (Ellis, 1989). This does not, of course, discount the complex and distinct sub-cultural groups who speak the same language (e.g. French speakers who are Moroccan, Congolese, Belgian, etc.). Cheung (2009) explained that personality instruments developed in Western cultures are often generalized to other cultural groups with the faulty assumption that these measures are valid for all groups. When a measure is adapted for a population that differs qualitatively from the one for which it was originally developed, the reliability and validity of the test must be evaluated before it can be clinically utilized (Butcher, Derksen, Sloore, & Sirigatti, 2003; Candell & Hulin, 1986; Cheung, 2009; Geisinger, 1994; Sireci & Berberoglu, 2000) and, hence, employed in the context of a medical–legal examination. Despite these recommendations, research on the language adaptations of the Personality Assessment Inventory (PAI; Morey, 1991, 2007) has been limited.The PAI is a self-report instrument that yields a broad range of clinically relevant information, and is a widely utilized test measure of personality and psychopathology in medical–legal examinations. It was developed using a rational and quantitative method of scale development. The rational criterion emphasizes theoretically informed choices when developing items, as opposed to empirically based instruments such as the Minnesota Multiphasic Personality Inventory–2 (MMPI–2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The PAI consists of 344 items that constitute four sets of non-overlapping scales: (a) four validity scales: Inconsistency, Infrequency, Negative Impression Management and Positive Impression Management; (b) 11 clinical scales: Somatic Complaints, Anxiety, Anxiety-Related Disorders, Depression, Mania, Paranoia, Schizophrenia, Borderline Features, Antisocial Features, Alcohol Problems and Drug Problems; (c) five treatment scales: Aggression, Suicidal Ideation, Stress, Nonsupport and Treatment Rejection; and (d) two interpersonal scales: Dominance and Warmth. Several advantages of the PAI include its brevity, lower reading level requirements, focus on diagnostic concepts and attention to clinical management issues. The acronyms for the scales and subscales are presented in