Cognitive status and profile validity on the Personality Assessment Inventory (PAI) in offenders with serious mental illness

Cognitive impairment among seriously mentally ill offenders has implications for legal matters (e.g., competency to stand trial), as well as clinical treatment and care. Thus, being able to identify potential cognitive concerns early in the adjudication process can be important when deciding on further interventions. In this study, we examined the validity scales of the Personality Assessment Inventory (PAI), scores on the Wechsler Adult Intelligence Scale-IV (WAIS-IV), and competency findings in male inmates (n = 61) diagnosed with a serious mental illness. Lower scores on the WAIS-IV significantly (p = 0.001) predicted invalid, versus valid, PAI profiles, with working memory impairment being the most significant (p = 0.004) predictor of an invalid profile. Ancillary analyses on a smaller sample (n = 18) indicate that those with invalid PAI profiles were more likely to be deemed legally incompetent (p = 0.03). These findings suggest that the PAI validity scales may be informative in detecting cognitive concerns and help clinicians make determinations about competency restoration and treatment.