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e NEO Inventories
PAU L T. C O S TA , J R .
R O B E R T R . M C C R A E
e NEO Personality Inventory–Revised (NEO-PI-R; Costa & McCrae,
1992b) and its variations are questionnaire measures of a comprehensive
model of general personality traits, the Five-Factor Model (FFM; Digman,
1990), or “Big Five.” e NEO-PI-R and a slightly simpli ed NEO-PI-3
(McCrae & Costa, 2010; McCrae, Costa, & Martin, 2005) consist of 240
items that assess 30 speci c traits, which in turn de ne the ve factors: Neu-
roticism (N), Extraversion (E), Openness to Experience (O), Agreeable-
ness (A), and Conscientiousness (C). e NEO Five-Factor Inventory-3
(NEO-FFI-3; McCrae & Costa, 2010) consists of selections of 60 of the
items that assess only the ve factors. Responses use a ve-point Likert
scale, from strongly disagree to strongly agree . Both self-report (Form S) and
observer rating (Form R) versions have been validated and extensively used
(Costa & McCrae, 1992b).
Although the NEO inventories are used around the world for basic
research on personality structure and development, they are also intended
for clinical use. Counselors, clinical psychologists, and psychiatrists can use
the personality pro les provided by the NEO inventories to understand the
strengths and weaknesses of the client, assist in diagnosis and the identi ca-
tion of problems in living, establish rapport, provide feedback and insight,
anticipate the course of therapy, and select optimal forms of treatment. In
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224 • Costa, Jr. and McCrae
this chapter we will provide an overview of the instruments and address
three basic questions:
1. What is the scienti c basis of the inventories?
2. For what populations are the NEO inventories appropriate?
3. How can clinicians use the instrument most e ectively?
eory and Development
roughout most of the 20th century, personality psychologists debated the
question of personality structure: What are the enduring individual di er-
ences that allow us to describe the distinctive features of a person, and how
are they organized? Some of this debate concerned the nature of the units—
should we measure needs, or traits, or temperaments, or character?—and
some concerned the nature and breadth of the factors or dimensions that
describe how the units are structured. Guilford had ten factors; Cattell six-
teen, Eysenck two or three. A er decades in which it seemed impossible to
reconcile these alternative models, it began to become clear in the 1980s
that ve factors were necessary and more or less su cient to encompass
the trait-descriptive terms in natural languages such as English and Ger-
man and that these same ve factors were found, in whole or in part, in
most measures of individual di erences (Digman, 1990; McCrae & John,
1992; Tupes & Christal, 1992). It is now known that the FFM incorporates
both normal and abnormal personality traits (Markon, Krueger, & Watson,
2005) and that it is a universal feature of the human species (McCrae et al.,
2005a), grounded in the human genome (Yamagata et al., 2006). Although
alternative models are still sometimes proposed (Ashton et al., 2004), it is
fair to say that the FFM is “the most scienti cally rigorous taxonomy that
behavioral science has” (H. Reis, personal communication, April 24, 2006).
Since their inception in 1978, the NEO inventories have been designed
to assess the most important general personality traits and the factors they
de ne, and they have grown with our understanding of the FFM. No single
theory of personality was used to guide development; instead, the selection
of traits was based on our reviews of the personality literature as a whole
(Costa & McCrae, 1980). At rst we distinguished only three major person-
ality factors—Neuroticism (N), Extraversion (E), and Openness to Experi-
ence (O) (whence the name); in the 1980s, work with the natural language
of personality traits convinced us that ve factors were needed to form a
comprehensive model (McCrae & Costa, 1985, 1987). We related these
factors to instruments based on Murray’s needs (Costa & McCrae, 1988),
Jung’s types (McCrae & Costa, 1989), Gough’s folk concepts (McCrae,
Costa, & Piedmont, 1993), and many other conceptions of personality, and
thus we grounded the FFM in personality theory (McCrae & Costa, 1996).
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e NEO Inventories • 225
To assess these traits, we developed scales using a combination of ratio-
nal and factor-analytic methods. Simple, straightforward items were written
that were intended to tap into each trait, and trial items were then analyzed
in large samples of adult volunteers. Targeted factor analyses were used to
select items that showed the best convergent and discriminant validity with
respect to the intended set of traits (Costa, McCrae, & Dye, 1991; McCrae
& Costa, 1983). e use of transparent items assumes that respondents are
willing and able to describe themselves accurately, and that premise has been
supported by a wealth of data on the multimethod validation of NEO scales
(e.g., McCrae et al., 2004). Many of these same studies support another
assumption—namely, that third-person rephrasings of the self-report items
would yield valid observer rating scales. Our choice of a ve-point Likert
response format (instead of true / false ) resulted in scales that provide accu-
rate assessments across the full range of the trait (Reise & Henson, 2000),
and our decision to use balanced keying eliminated most of the problematic
e ects of acquiescent responding (McCrae, Herbst, & Costa, 2001).
When rst published (Costa & McCrae, 1985), the NEO Personality
Inventory consisted of 180 items, with six facet scales for each of the Neu-
roticism (N), Extraversion (E), and Openness to Experience (O) domains,
and brief global scales to measure Agreeableness (A) and Conscientious-
ness (C). Four years later we introduced the short version, the NEO-FFI, as
well as new norms appropriate for use with college-age and adult respon-
dents (Costa & McCrae, 1989). In 1992 the NEO-PI-R appeared, with new
facet scales for A and C, and replacement of 10 of the original N, E, and O
items. In 1994 a Spanish translation intended for use by Hispanics was pub-
lished (Psychological Assessment Resources, 1994), and translations have
now been made into over 40 languages. Research showed that the inventory
could be used by children as young as 10, but that some items were di -
cult for adolescents to understand; a more readable version, the NEO-PI-3,
has been developed, along with a NEO-FFI-3. ese instruments can be
used by both adolescents (age 12 and older) and adults, and they may be
particularly useful in populations with limited literacy. e NEO-PI-3 and
the NEO-FFI-3 were published in 2010. Computer administration, scoring,
and interpretation has been available since 1985; major updates, with many
features intended for the clinical use of the instrument, were released in
1994 and again in 2010 (Costa, McCrae, & PAR Sta , 1994, 2010).
e NEO-PI-3 and the NEO-FFI-3 introduced a number of features
discussed in the 2010 Professional Manual, including the NEO Problems
in Living Checklist (NEO-PLC), a tool for clinicians to assess problematic
behaviors and symptoms associated with a NEO-PI-3 or NEO-PI-R pro le;
the NEO Style Graph Booklet, a new way to provide feedback to respon-
dents; the NEO Job Pro ler, a tool to identify traits relevant to an occupation
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226 • Costa, Jr. and McCrae
or position; adolescent norms for the observer rating version of the NEO-
FFI-3 as well as supplementary norms for di erent age groups and for inter-
national comparisons; a glossary of NEO-PI-3 words for respondents with
limited literacy; and a list of published translations of the NEO inventories.
All the NEO inventories assess the ve factors. Because these broad con-
structs summarize so much information, they are the logical starting place
for personality assessment. ey explain whether the client is chronically
predisposed to emotional distress versus emotionally stable (N); ener-
getic and thrill-seeking versus sober and solitary (E); curious and uncon-
ventional versus traditional and pragmatic (O); kind and trusting versus
competitive and arrogant (A); disciplined and fastidious versus laidback
and careless (C). e domain scales of the NEO-PI-R and NEO-FFI pro-
vide measures of all ve factors; more precise estimates can be obtained as
NEO-PI-R or NEO-PI-3 factor scores.
Much research on the FFM has employed global measures that assess
only the ve factors. But for clinical purposes, we recommend the full-
length inventories that provide detailed information on 30 distinct traits.
is information can a ect the interpretation of the overall factor. For
example, a client who scores very high on E3: Assertiveness but average
on E1: Warmth may have the same high Extraversion (E) score as one who
scores very high on Warmth but only average on Assertiveness—yet surely
these two clients are likely to have rather di erent interpersonal styles: the
former will be forceful and directive, while the latter will be more friendly
and invested in others. e constructs assessed by the NEO-PI-R facets
are suggested by their labels, but prior to using the instrument, clinicians
should study the descriptions of the individual facets given in the Manual
(Costa & McCrae, 1992b; McCrae and Costa, 2010).
Scores from the NEO inventories can also be interpreted by examining
pairs of factors, called styles . For example, the style of Impulse Control is
based on scores for Neuroticism (N) and Conscientiousness (C): High N,
high C is called Overcontrolled; high N, low C is Undercontrolled; low N,
low C is Relaxed; and low N, high C is Directed. Style graphs describe each
of these styles. For example, clients who have an Overcontrolled style “have
perfectionistic strivings and will not allow themselves to fail even in the
smallest detail ... they are prone to guilt and self-recrimination. ey may
be susceptible to obsessive and compulsive behavior” (Costa, McCrae, &
PAR Sta , 2010).
Internal consistencies of the 48-item domain scores are high. For exam-
ple, in an adult sample ( N = 635), coe cient alphas for Neuroticism (N),
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e NEO Inventories • 227
Extraversion (E), Openness to Experience (O), Agreeableness (A), and
Conscientiousness (C) domain scores from the NEO-PI-R were .92, .89,
.88, .90, and .91, respectively, for Form S and .93, .90, .88, .93, and .93 for
Form R (McCrae, Martin, & Costa, 2005). e corresponding values for
14- to 20-year-olds ranged from .87 to .94 (McCrae, Costa, et al., 2005).
Coe cient alphas for the eight-item facet scales are understandably lower;
in the adult sample they ranged from .51 to .86 ( Mdn s = .75 for Form S,
.78 for Form R); in the adolescent sample they ranged from .44 to .84
( Mdn s = .73 for Form S, .75 for Form R). Internal consistencies below .70
are sometimes considered problematic, but the few NEO-PI-R facet scales
with values lower than .70 have nevertheless shown evidence of heritability,
cross-observer agreement, and longitudinal stability comparable to those of
the more internally consistent facets (McCrae, Kurtz, Yamagata, & Terrac-
ciano, 2011). Internal consistencies for the ve 12-item Form S NEO-FFI-3
domain scales ranged from .71 to .87 for middle-school children, .72 to .83
for adolescents, and .79 to .86 for adults (McCrae & Costa, 2007).
Robins, Fraley, Roberts, and Trzesniewski (2001) reported two-week
retest reliabilities of .86 to .90 for the NEO-FFI scales. McCrae, Yik, Trapnell,
Bond, and Paulhus (1998) reported two-year retest reliabilities for the full
NEO-PI-R; coe cients for N, E, O, A, and C were .83, .91, .89, .87, and .88.
Retest reliabilities for the 30 facet scales ranged from .64 to .86 ( Mdn = .79).
McCrae, Kurtz, and colleagues (2011) reported one-week retest coe cients
of .70 to .91 for the facets and .91 to .93 for the domains in a sample of 132
college students. Terracciano, Costa, and McCrae (2006) reported 10-year
stability coe cients for the NEO-PI-R. e median value was .70 for facets
and .81 for factors.
As an operationalization of the FFM, the foremost test of the validity of
the NEO-PI-R is the replicability of its factor structure, and this has been
the topic of dozens of articles. e structure has been satisfactorily recov-
ered in adults, college students, and children as young as 12, in men and
women, and in black and white Americans (Costa et al., 1991). Recently,
observer rating data were obtained from 50 cultures using translations of
the NEO-PI-R into over 20 languages (McCrae et al., 2005a). Of 250 factor
congruence coe cients, 236 (94.4%) were higher than .85, indicating factor
replication (Haven & ten Berge, 1977), and all but one were signi cantly
higher than chance. Deviations from the intended structure were found
only in cultures where the quality of the data was low (for example, where
the respondents took the test in a second language).
Cross-observer agreement is key in evaluating the validity of any per-
sonality inventory. On one hand, human judges who are well acquainted
with the target can integrate a wealth of knowledge into an accurate assess-
ment of personality; on the other hand, they do not share the artifacts that
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228 • Costa, Jr. and McCrae
can in ate the correlation of one self-report with another. To the extent
that a self-report and an observer rating agree, both are likely to be valid.
Cross-observer validity for the NEO inventories has been repeatedly
demonstrated, with correlations generally in the .40 to .60 range—far above
the so-called .3 barrier once thought to represent the limit of validity for
trait measures. In analyses of the NEO-PI-3, self/other correlations for
Neuroticism (N), Extraversion (E), Openness to Experience (O), Agree-
ableness (A), and Conscientiousness (C) factors ranged from .56 to .67
(McCrae, 2008). Bagby and colleagues (1998) reported comparable correla-
tions in a sample of depressed outpatients. Using a Mandarin translation of
the NEO-PI-R, Yang and colleagues (1999) reported agreement between
Chinese psychiatric patients and their spouses ranging from .32 to .51 ( N =
160, all p s < .001). Soldz, Budman, Demby, and Merry (1995) found mod-
est agreement between group psychotherapy patients’ NEO-PI scores and
other group members’ ratings on an adjective measure of the FFM.
Note, however, that these correlations seldom approach 1.0. Di erent
observers have di erent opinions about an individual’s personality, and the
views of all informed observers are worth considering. Indeed, discrepan-
cies in perceptions between members of a couple may be particularly infor-
mative (Singer, 2005).
e validity of NEO scales is attested by the results published in over
2,000 articles, chapters, and books. NEO scales have been correlated in
meaningful ways with scales from the Minnesota Multiphasic Personality
Inventory (MMPI; Hathaway & McKinley, 1983; Siegler et al., 1990), the
Millon Clinical Multiaxial Inventory (Lehne, 2002), the Personality Assess-
ment Inventory (PAI; Morey, 1991), and the Basic Personality Inventory
(Costa & McCrae, 1992a). ey have proven useful in predicting vocational
interests (De Fruyt & Mervielde, 1997), ego development (Einstein & Lan-
ning, 1998), attachment styles (Shaver & Brennan, 1992), and psychiatric
diagnoses of personality disorders (McCrae, Yang, et al., 2001).
In the past 20 years, the FFM has become the dominant model in per-
sonality psychology (Funder, 2001; Markon et al., 2005), consolidating
decades of research on personality structure. Of the many operationaliza-
tions of the FFM, the most widely used and extensively validated are the
Administration and Scoring
Instructions for the administration and scoring of the NEO-PI-R and
NEO-PI-3 are given in the manual (McCrae & Costa, 2010). e instrument
can be administered to individuals or groups, and it can be administered
orally to those with limited literacy or visual problems. Both machine- and
hand-scoring answer sheets are available; the test booklet is reusable.
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e NEO Inventories • 229
e NEO-PI-3 is intended for individuals age 12 and older, while the
NEO-PI-R is intended for individuals aged 18 and older, although it has
been used successfully with high-school students (McCrae et al., 2002). It
has a Flesch-Kincaid reading level of 5.7 overall. e NEO-PI-3, in which
37 NEO-PI-R items were replaced, has an overall Flesch-Kincaid level of
5.3 and eliminated most of the items that were di cult for adolescents to
understand. It can be used by adults or by children as young as 12. If respon-
dents do not understand an item, the administrator can explain it; suggested
language is provided for use with the NEO-PI-3 (Costa, McCrae, & Martin,
e publisher has classi ed the NEO inventories as Level B or S, mean-
ing that they are available to individuals with a college degree in psychology
or a related discipline or in one of the health care professions, provided that
they have appropriate training in the use and interpretation of psychologi-
cal tests. We assume that users will familiarize themselves with the Manual .
Perhaps the most important requirement is that the administrator make
every e ort to engage the cooperation of the respondent. Providing a com-
fortable setting and ample time, giving assurances of privacy, explaining the
purpose of testing, and perhaps o ering feedback can minimize problems
of careless or distorted responding.
e NEO So ware System (Costa et al., 2010) administers, scores, and inter-
prets the NEO-PI-R, NEO-PI-3, and NEO-FFI-3. Interpretive statements
re ect our understanding of ranges of scores. For example, an individual
whose most extreme score is T = 72 on the Openness to Experience (O)
factor would receive a report that begins:
e most distinctive feature of this individual’s personality is his
standing on the factor of Openness. Very high scorers like him
have a strong interest in experience for its own sake. ey seek out
novelty and variety, and have a marked preference for complexity.
ey have a heightened awareness of their own feelings and are
perceptive in recognizing the emotions of others ... Peers rate such
people as imaginative, daring, independent, and creative.
e NEO-PI-R Interpretive Report provides a graphic pro le, a discus-
sion of protocol validity, descriptions at the level of factors and facets, and
a summary of personality correlates based on published ndings. A clin-
ical module calculates pro le agreement statistics that lead to hypotheses
about possible Axis II diagnoses. Another module provides a description of
personality suitable for use as client feedback. A special feature allows the
clinician to input two di erent assessments (e.g., a self-report and a spouse
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230 • Costa, Jr. and McCrae
rating); this generates a combined report based on the adjusted average of
the two sets of scores and calls attention to traits on which there is substan-
tial disagreement, suggesting the need for additional inquiry. Optionally,
the report can include a list of potential Problems in Living that the clini-
cian can use as a guide to a focused interview. For example, a client who
scores low on Conscientiousness might show “Poor academic performance
relative to ability” or “Problematic health habits that lead to medical prob-
lems,” and the clinician may wish to inquire about these issues.
Reise and Henson (2000) showed that the items of the NEO-PI-R could
be used in a Computer Adaptive Testing system, but this is not currently
Applications and Limitations
Settings and Uses
As general personality trait measures, the NEO inventories can be used in
a wide variety of settings. ey have been widely used in clinical practice in
both inpatient (Yang et al., 1999) and outpatient (Piedmont, 2001) settings.
Health psychologists use them in medical settings (Christensen & Smith,
1995). e questionnaire can be mailed to respondents.
e NEO inventories are useful in a wide variety of contexts, from
selecting police in New Zealand (Black, 2000) to documenting personal-
ity changes in Alzheimer’s disease (Strauss & Pasupathi, 1994) to school
counseling (Scepansky & Bjornsen, 2003). For the clinician, these measures
are particularly valuable, because they assess strengths as well as weak-
nesses. Measures of psychopathology are useful in identifying problems but
may give few clues about the client’s creativity, organization, or generosity.
Inventories like the MMPI that are supposed to assess both normal and
abnormal aspects of the individual o en lack the scope of the NEO-PI-R
with respect to general personality traits. For example, the MMPI lacks
Quick Reference 6.1
e NEO inventories are available from Psychological Assessment Resources, 16204
N. Florida Avenue, Lutz, FL 33549. Fax: 1-800-727-9329. Phone: 1-800-331-8378.
Web site: www.parinc.com .
To request a license to adapt the instruments or use an authorized translation, e-mail
Customer Support at email@example.com.
A bibliography of articles, chapters, and presentations using NEO Inventories
is available at www4.parinc.com/WebUploads/samplerpts/NEO%20Biblio%20
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e NEO Inventories • 231
items that measure Conscientiousness (C) (Johnson, Butcher, Null, & John-
son, 1984). e full-length NEO-PI-R and NEO-PI-3 assess 30 facet scales
as well as the ve factors, and these facet scales have incremental validity in
predicting behaviors (Paunonen & Ashton, 2001) and personality disorder
symptoms (Reynolds & Clark, 2001); thus, these instruments are prefera-
ble to the shorter NEO-FFI and other Big Five measures that provide only
A relatively novel feature of the NEO inventories is their emphasis on
feedback. A brief, non-threatening description of high, low, and average
scores for the ve factors is provided by Your NEO Summary ; the admin-
istrator checks the appropriate level for each factor. is sheet has been
widely used as an incentive for research volunteers and an educational tool
for psychology students.
Traditionally, psychological assessments were not shared with clients, on
the assumption that results might be misunderstood or distressing. ese
concerns do not appear to be applicable to the NEO inventories because
of the general nature of the traits they assess, and many clinicians discuss
plotted NEO pro les with patients as part of the therapeutic process (e.g.,
Singer, 2005). Mutén noted that even high Neuroticism (N) scores are not
problematic: “Most people who score very high on N facets are well aware
of their depression, hostility, or impulsiveness and appear to welcome a
candid discussion” (1991, p. 454). At the request of clinicians, the NEO
So ware System now includes a Client Report that gives a detailed explana-
tion of factor and facet scores in lay language.
e NEO inventories assess general personality traits. Although these cover
a wide range of emotional, interpersonal, experiential, attitudinal, and
motivational characteristics of the individual, they do not constitute a com-
plete psychological assessment. ey do not address cognitive abilities or
distortions. Although they can be interpreted as a guide to likely problems
in living or psychopathology, they do not assess these conditions directly.
A client who scores very low on Agreeableness (A) is likely to have inter-
personal problems, but the clinician must determine by interview or other
assessment instruments exactly what those problems are, and whether they
merit attention as a focus of treatment. Certain pro les can suggest Axis II
diagnoses, but one cannot determine from the NEO-PI-R alone whether
the client meets DSM-IV criteria for a personality disorder.
Use of the NEO inventories is not appropriate in all situations. Respon-
dents must have a minimal level of intellectual competence and must not be
demented, delirious, or oridly psychotic. However, illiterate clients can be
administered the instrument orally, and clients with many kinds of severe
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232 • Costa, Jr. and McCrae
mental disorder, such as acute major depression, can nevertheless provide
valid information through self-reports (Costa, Bagby, Herbst, & McCrae,
2005). For other patients, such as those with dementia or mental retarda-
tion, observer ratings from knowledgeable informants provide clinically
useful data (Bagby et al., 1998).
Of particular concern are questions of motivated test distortion. Although
there are some simple checks on protocol validity, the NEO inventories
do not include validity scales intended to detect lying, defensiveness, or
malingering. Such scales have been proposed (Schinka, Kinder, & Kremer,
1997), but we have not incorporated them into the scoring of the instru-
ment because we are not convinced that such scales actually work (see, e.g.,
Morey, Quigley, et al., 2002; Piedmont, McCrae, Riemann, & Angleitner,
2000; Yang, Bagby, & Ryder, 2000). We discuss this issue in detail below,
under “Current Controversies.” is precludes the use of the NEO inven-
tories in a few contexts. For example, a study of child custody litigants
(Langer, 2004) showed that ex-spouses described each other as almost three
standard deviations lower than they described themselves on Agreeableness
(A) and Conscientiousness (C). It is not clear whether any questionnaire
measure could provide valid assessments in such a situation.
Contributions to Psychotherapy and Treatment Planning
Scales from the NEO inventories have been linked to a wide range of
psychiatric diagnoses, and a clinician familiar with this literature would
be guided toward many diagnoses. For example, individuals very low in
Agreeableness (A) and Conscientiousness (C) are prone to psychopathy
(J. D. Miller, Lynam, Widiger, & Leukefeld, 2001) and substance abuse
(Ball, Tennen, Poling, Kranzler, & Rounsaville, 1997); those scoring high
on Neuroticism (N) and low on Extraversion (E) are prone to depression
(Bagby et al., 1998). e most intensive research, however, has been on the
utility of NEO-PI-R scores as predictors of Axis II personality pathology.
Widiger, Costa, Gore, and Crego (2013) reviewed a large body of research
that shows that particular patterns of NEO-PI-R pro les are associated in
theoretically meaningful ways with DSM personality disorders. For exam-
ple, individuals diagnosed with Paranoid Personality Disorder generally
score high on N2: Angry Hostility and low on A1: Trust, A2: Straightfor-
wardness, and A4: Compliance. e NEO inventories computer Interpretive
Report includes a Clinical Hypotheses section, in which prototype pro les
for the personality disorders are compared to client pro les. If pro le agree-
ment is substantially higher than that normally found in nonclinical pop-
ulations, the clinician is alerted to the possibility that the client may have
features of the disorder. We (Costa & McCrae, 2005) have proposed a sim-
pli ed system for hand scoring NEO-PI-R personality disorder scales that
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e NEO Inventories • 233
can yield the same clinical hypotheses (see also J. D. Miller, Bagby, Pilkonis,
Reynolds, & Lynam, 2005). Clinicians are cautioned that these hypotheses
need to be con rmed by evaluation of the DSM diagnostic criteria.
However, the DSM-IV categorical personality disorders have been widely
criticized: ey are arbitrary, show serious comorbidity, are unstable over
time, and generally lack empirical foundation (McCrae, Löckenho , & Costa,
2005). Instead of attempting to predict membership in one of these rather
dubious categories, Widiger, Costa, and McCrae (2013) have proposed that
clinicians assess the factors and facets of the FFM and then focus on problems
or symptoms associated with high or low standing on each. For example, a
client who scores high on C2: Order may be “preoccupied with order, rules,
schedules, and organization ... [T]asks remain uncompleted due to a rigid
emphasis on proper order and organization; friends and colleagues frustrated
by this preoccupation” (Widiger, Costa, & McCrae, 2013, p. 296). Of course,
not all clients who score high on C2: Order will have these problems, but
the clinician should inquire about these issues and may discover problems in
living that should become a focus of treatment. If they are su ciently severe,
they may warrant a diagnosis. Under Widiger et al.’s proposal, this would
be styled a C+PD (high Conscientiousness personality disorder); under the
existing Axis II it would be Personality Disorder Not Otherwise Speci ed.
Among the rst clinicians to appreciate the value of the NEO-PI-R in
treatment planning was T. Miller (1991). Drawing on his experience with
a series of 119 clients, he reported that information from the NEO-PI was
useful in understanding the client and in anticipating problems in therapy.
He o ered a list of key problems, treatment opportunities, and treatment
pitfalls associated with each of the factors. For example, a client who is
high in Agreeableness (A) is likely to form a therapeutic alliance easily but
may be so uncritical in accepting interpretations that the therapy misses
the essential problems. Traits can also suggest the most promising forms of
therapy: Clients high in Openness to Experience (O) may enjoy and pro t
from imaginative role-playing, whereas those low in O may prefer concrete
therapies such as behavior modi cation.
More recently, implications of NEO scores for the treatment of personal-
ity disorders have been discussed by Stone (2013) and others in the Widiger
and Costa (2013) volume. Harkness and McNulty (2002) went beyond the
use of trait information in characterizing a patient; they draw out the impli-
cations for psychotherapy of the whole body of individual di erences sci-
ence. For example, evidence on the heritability and stability of personality
traits suggests that it will be useful to adopt realistic expectations for what
can and cannot be changed in therapy and to focus therapeutic interven-
tions on the client’s characteristic maladaptations rather than on the endur-
ing underlying traits they express.
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234 • Costa, Jr. and McCrae
Singer (2005) integrated trait psychology into a program for treating the
whole person and found that the NEO-PI-R has great utility in the crucial
rst phase of beginning to understand the patient. Because it assesses both
broad factors and speci c facets, and because patterns and combinations of
facets can be interpreted by the experienced clinician, it provides a wealth
of data. As Singer illustrated in a case study of therapy for a couple, even
richer characterizations can be obtained by examining both self-reports
and ratings from a knowledgeable informant.
Treatment planning. Several studies have shown that the NEO invento-
ries can be helpful in anticipating the course of therapy and predicting out-
comes. Mattox (2004) assessed the personality of 53 undergraduates who
participated in a mock interview with clinical psychology students; the
interviewers, participants, and two observers rated the treatment alliance
established in the single session. NEO-PI-R Extraversion (E) was signi -
cantly related to all three assessments of alliance, probably because extra-
verts excel in initiating social contacts. (In the long term, Agreeableness
may be more important for the treatment alliance; see T. Miller, 1991.)
Ogrodniczuk, Piper, Joyce, McCallum, and Rosie (2003) assessed per-
sonality with the NEO-FFI before treatment by interpretive or supportive
group therapy in a sample of 107 patients with complicated grief reactions.
ose patients who were initially higher in Extraversion (E), Openness
to Experience (O), and Conscientiousness (C), and lower in Neuroticism
(N), showed more favorable outcomes in both treatments, whereas patients
high in Agreeableness (A) showed better outcomes only in the interpretive
Talbot, Duberstein, Butzel, Cox, and Giles (2003) examined the in u-
ence of personality on outcomes to two di erent therapies in a sample of
86 women with histories of childhood sexual abuse. A Women’s Safety in
Recovery (WSIR) group was a highly structured treatment that focused
on problem-solving skills for dealing with current problems. Comparison
Just the Facts 6.1
Ages: 12 to 99+
Purpose: Provide a comprehensive assessment of general personality traits.
Strengths: Assesses the best-established model of personality structure using
either self-report or observer rating methods; provides scales with demonstrated
longitudinal stability and cross-cultural generality. Feedback can be provided.
Limitations: Susceptible to conscious distortion under some circumstances.
Time to Administer: 35–45 minutes.
Time to Score: 5 minutes.
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e NEO Inventories • 235
with a less structured treatment-as-usual group showed that women low in
Agreeableness (A) and Extraversion (E) bene ted most in the WSIR group.
ese ndings are consistent with other research showing that highly struc-
tured therapies are more e ective for introverted patients (Bliwise, Fried-
man, Nekich, & Yesavage, 1995).
Lozano and Johnson (2001) examined manic and depressive symptoms
in 39 bipolar patients. High Neuroticism (N) predicted increased depres-
sive symptoms, whereas high Conscientiousness (C) predicted increasing
manic symptoms, consistent with the “increase in goal-directed activity”
noted by the DSM-IV as a criterion for a manic episode.
Psychotherapy is only possible when the client is willing to accept treat-
ment. Hill, Diemer, and Heaton (1997) asked which students were willing
to participate in a therapeutic dream interpretation session. Of 336 students
initially assessed on the NEO-FFI, 109 indicated an interest in participat-
ing, and 65 of these attended the session. Whether or not they actually par-
ticipated, students who were interested in dream interpretation sessions
scored nearly three-quarters of a standard deviation higher in Openness to
Experience (O) than those who were not. Dream interpretation is probably
not a therapeutic option for very closed patients.
Treatment progress evaluation . In nonclinical samples, the traits assessed
by the NEO inventories are highly stable over time (Terracciano et al., 2006).
Even in patients treated for psychiatric disorders, stability rather than plas-
ticity is the rule (Costa et al., 2005). As a result, Harkness and McNulty
(2002) have argued that substantial change in personality trait levels is not
a realistic goal of psychotherapy, which should focus instead on how traits
are manifested in concrete problems in living.
Nevertheless, true personality change is sometimes the result of psycho-
therapy, especially when the disorder, such as major depression, has a neu-
rochemical basis. Two studies have shown that NEO trait levels are a ected
by pharmacological treatments for depression—but only among patients
who respond to medication (Costa et al., 2005; Du, Baksih, Ravindran, &
Hrdina, 2002). In both studies, Neuroticism (N) decreased and Extraver-
sion (E) increased as the result of successful treatment. Piedmont (2001)
assessed personality change in 99 outpatient drug rehabilitation patients. At
the end of a six-week treatment program, there were signi cant decreases
in N and increases in Extraversion (E), Openness to Experience (O), Agree-
ableness (A), and Conscientiousness (C); the e ects for N, A, and C were
also seen in a subsample followed 15 months later.
e changes seen in all three studies were modest in magnitude. For
example, in Piedmont’s follow-up sample, mean Neuroticism (N) T scores
declined from 63 to 58; among Costa et al.’s (2005) responders, N declined
from 72 to 62. Compared to the normal average T score of 50, both sets of
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236 • Costa, Jr. and McCrae
e ectively treated patients remained high in N. As Harkness and McNulty
(2002) would have predicted, therapy did not radically alter basic person-
ality traits. Nevertheless, the changes seen are statistically and clinically
signi cant, and they demonstrate that the NEO inventories are capable of
registering change when it occurs. at is also shown by a study of caregiver
ratings of Alzheimer’s disease patients (Strauss & Pasupathi, 1994): e per-
sonality changes that characterize that disease could be detected through
observer ratings on the NEO-PI-R over a period as short as one year.
Psychiatrists and clinical psychologists trained in the use of the DSM are
familiar with categorical models of psychopathology, in which patients
either do or do not have a disorder. It is sometimes claimed that clinicians
are so accustomed to categorical or typological thinking that they would
not be able to use dimensional models of personality. Samuel and Widiger
(2006) put this claim to the test. ey provided descriptions of individuals
with personality pathology and asked the clinicians to describe the indi-
viduals in terms of the FFM and the DSM-IV personality disorders. When
asked to evaluate these two characterizations, the clinicians preferred the
FFM for describing personality, communicating with the patient, covering
the full range of problems, and formulating e ective treatments. e FFM
and the NEO inventories are clinician-friendly.
e NEO Inventories Bibliography ( www4.parinc.com/WebUploads/
samplerpts/NEO%20Biblio%202011_1.pdf ) lists over 400 publications in
its section on Counseling, Clinical Psychology, and Psychiatry. Many of
these refer to studies concerning personality disorders collected in Widiger
and Costa (2013) or published as part of the Collaborative Longitudinal
Personality Disorders Study (e.g., Morey, Gunderson, et al., 2002). In this
section we review selected studies on other aspects of psychopathology and
Katon and colleagues (1995) showed that patients who do not meet
DSM-III-R criteria for panic disorder because their attacks are infrequent
score just as high on NEO-PI-R Neuroticism (N) as patients who do, and
much higher than controls. Further, despite the fact that they did not meet
diagnostic criteria, patients with infrequent panic attacks showed as much
disability as those who obtained the diagnosis. In this case, N was a better
predictor of disability than diagnostic status was.
It is well known that Neuroticism (N) is associated with clinical depression—
indeed, one of the NEO-PI-R facet scales is N3: Depression. But Wolfenstein
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e NEO Inventories • 237
and Trull (1997) showed that NEO-PI-R Openness to Experience (O), a fac-
tor rarely measured by clinical instruments, is also a predictor of depressive
symptoms in a college sample. Although O is generally regarded as a desirable
trait, the sensitivity it imparts also puts some individuals at risk for depressive
Nigg and colleagues (2002) used data from 1,620 respondents in six
community and clinical samples to link symptoms of childhood or current
attention de cit/hyperactivity disorder (ADHD) to self-reports and (in one
sample) spouse ratings on the NEO-FFI. ey found that the inattention-
disorganization cluster of ADHD symptoms was strongly related to low
Conscientiousness (C), whereas the hyperactivity and oppositional symp-
toms were associated with low Agreeableness (A). Some of these correlations
were strikingly large; for example, Attention Problems showed correlations
ranging from –.42 to –.78 with C. Results from self-reports were replicated
when spouse ratings were analyzed, suggesting that both Forms are useful
in clinical assessment.
Quirk, Christiansen, Wagner, and McNulty (2003) addressed the criti-
cal question of incremental validity: Do NEO-PI-R scores tell the clinician
anything more than assessment with standard clinical instruments? To
answer this question, they administered the NEO-PI-R and the MMPI-2
to a sample of 1,342 inpatient substance abusers and predicted Axis I and
Axis II diagnoses. ey concluded that NEO-PI-R scales were substantially
McCrae, R. R., & Costa, P. T., Jr. (2003). Personality in adulthood: A Five-Factor eory perspec-
tive (2nd ed.). New York: Guilford Press.
is book focuses on adult personality development, but includes non-technical
introductions to the psychometric and theoretical bases of the NEO-PI-R.
McCrae, R. R., & Costa, P. T., Jr. (2010). NEO Inventories professional manual . Odessa, FL:
Psychological Assessment Resources.
is is the basic reference for the instruments, with summaries of research until 2010.
Piedmont, R. L. (1998). e Revised NEO Personality Inventory: Clinical and research
applications. New York: Plenum.
A book-length guide to clinical use of the instrument.
Singer, J. A. (2005). Personality and psychotherapy: Treating the whole person. New York:
Reports an attempt to integrate therapy at the level of traits, characteristic adaptations,
life narratives, and relational dynamics. Both individual and couple case studies illustrate
use of the NEO-PI-R.
Widiger, T. A., & Costa, P. T., Jr. (Eds.). (2013). Personality disorders and the Five-Factor Model
of personality (3rd ed.). Washington, DC: American Psychological Association.
is volume reports research, theory, and practical applications of the FFM in the con-
text of DSM personality disorders. Chapter 19 presents a radical proposal for dimen-
sionalizing Axis II and diagnosing a personality disorder using the FFM.
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238 • Costa, Jr. and McCrae
related to most diagnoses they examined and that they explained variance
above and beyond that accounted for by 28 MMPI-2 scales. ey also
showed that NEO-PI-R facet scales provide additional information over
the ve domain scales and that facet scales from each of the ve factors
contributed incrementally to the prediction of diagnoses. For example, O1:
Fantasy made a unique contribution to the diagnosis of bipolar disorder,
and low E2: Gregariousness made a unique contribution to the diagnosis
of posttraumatic stress disorder. Quirk and colleagues concluded that their
results “support the use of FFM scales in an adjunct role in clinical assess-
ment” (p. 323).
With versions in over 40 languages, the NEO inventories are among the
most widely used psychological tests in the world. Published versions, com-
plete with manuals and local normative information, are available in Bul-
garian, Croatian, Czech/Slovak, Danish, Dutch, Finnish, French, German,
Hebrew, Japanese, Korean, Lithuanian, Norwegian, Polish, Portuguese,
Romanian, Russian, Spanish, Turkish, and British English. Chinese, Hindi,
Arabic, Italian, and many other versions are available from the publisher by
license (usually without normative information).
When psychological measures are translated and used in a new cultural
context, it cannot be assumed that their meaning has been retained. e
characteristics assessed may not exist in the new culture, or the items may
not validly assess them. Some evidence of construct validity must be o ered
for each new translation. In the case of the NEO-PI-R, the most straightfor-
ward criterion of construct validity is found in factor replicability. A valid
measure of anxiety ought to load on the same general factor as measures
of depression and vulnerability; recovery of the Neuroticism (N) factor is
thus a form of evidence that meaning has been retained. Demonstrations
of factor replicability for the NEO-PI-R have been published in dozens
of languages, for both self-reports (McCrae & Allik, 2002) and observer
ratings (McCrae et al., 2005a). In addition, cross-cultural evidence of con-
struct validity has been demonstrated in meaningful patterns of correlates,
including cross-observer agreement (McCrae et al., 2004). e quality of
data varies across translations and cultures, and in some cases further adap-
tation and re nement is clearly needed, but the NEO inventories appear to
be promising research and clinical tools anywhere.
Use of any validated NEO translation within a culture seems appropriate.
Much more controversial is the comparison of scores across cultures (e.g.,
Poortinga, van de Vijver, & van Hemert, 2002). e e ect of translation may
be to make items more easy or di cult; di erent cultures may have di er-
ent self-presentational styles; frames of reference may vary; acquiescence or
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e NEO Inventories • 239
extreme responding may introduce systematic cultural biases. All of these
are threats to what is known as scalar equivalence , which is a prerequisite to
meaningful cross-cultural comparisons. McCrae and colleagues (2005b) have
argued that if cross-cultural comparisons yield meaningful results, the data
must have shown at least rough scalar equivalence, and they have o ered
evidence of such meaningful results. For example, cultures scoring high in
Power Distance (a cultural pattern in which people show authoritarian defer-
ence to those of higher status) have individuals who, on average, score low on
NEO-PI-R Openness to Experience (O) (McCrae et al., 2005b).
e merits and limitations of this argument are perhaps of little interest
to clinicians, but they have an important practical application. If McCrae
and colleagues are correct, then scalar equivalence for well-constructed
personality tests is the rule, not the exception; and if this is so, then raw
scores from anywhere in the world are comparable. In particular, one could
use American norms to interpret the NEO-PI-R pro le of a client from
Singapore or Zimbabwe—provided one recalls that the client is being com-
pared to Americans. Because Americans (on average) are more extraverted
than most people in the world, most people would appear relatively intro-
verted when judged by American norms, even though they might be more
extraverted than their compatriots. Where local norms are available, they
are preferable—so long, once again, as one recalls that the client is being
compared to the local group.
An instrument that works in Sweden, Burkina Faso, and Indonesia is
likely to work well in minority groups in North America. e NEO inven-
tories have been used e ectively to assess personality in Chinese Canadians
(McCrae et al., 1998), African Americans (Terracciano, Merritt, Zon-
derman, & Evans, 2003), and Hispanics (Benet-Martínez & John, 1998).
Simakhodskaya (2000) used a Russian translation to study acculturation in
Russian emigrants to the United States; Moua (2006) studied the structure
of personality in Hmong Americans.
e most controversial issue in the clinical use of the NEO inventories has
always been the role of validity scales (Ben-Porath & Waller, 1992). Psycho-
metricians have known for decades that questionnaire measures are subject
to a variety of biases that threaten their validity. Among these are response
styles including acquiescence, nay-saying, and extreme responding; faking,
including both positive and negative impression management; and random
responding, either with a mixed pattern of answers or with a single repeated
response. Most clinical instruments, including the MMPI and the PAI, have
extensive validity scales to detect and correct for these kinds of biases. e
NEO inventories do not.
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240 • Costa, Jr. and McCrae
e NEO-PI-3 does include some checks on protocol validity. At the
bottom of the answer sheet, a statement and two questions are presented:
“I have tried to answer all of these questions honestly and accurately,”
“Have you responded to all of the statements?” and “Have you entered your
responses in the correct areas?” Respondents who strongly disagree or dis-
agree with the rst statement, and those who say no to the last, are consid-
ered to have invalid data. Protocols are not scored if more than 40 items are
missing. In the computer version, strings of repetitive responses are noted,
and protocols with more than 6 consecutive strongly disagree s, 9 disagree s,
10 neutral s, 14 agree s, or 10 strongly agree s are considered invalid, because
longer strings were never found in a large, cooperative sample. (When
using the hand-scored version, a visual sweep of the answer sheet can o en
spot suspicious response patterns.)
Carter and colleagues (2001) examined the stability of NEO-PI-R scores
in a sample of 301 opioid-dependent outpatients. In this drug-abusing sam-
ple, a large number (71) of protocols were deemed invalid by these rules. e
four-month retest correlations for the valid protocols were .72, .68, .74, .72,
and .71 for Neuroticism (N), Extraversion (E), Openness to Experience (O),
Agreeableness (A), and Conscientiousness (C), respectively; the corre-
sponding values for the invalid protocols were .48, .48, .46, .57, and .38. In a
sample of 500 adolescents with valid protocols on the NEO-PI-3, coe cient
alphas for the ve domains ranged from .87 to .95; in a sample of 36 ado-
lescents with invalid protocols, they ranged from .75 to .90 (McCrae, Costa,
et al., 2005). Both these studies show that the validity rules successfully dis-
tinguish more-valid protocols from less-valid ones. But they also show that
there is still valid information in “invalid” protocols. Clinicians should be
reluctant to discard any assessment, although some assessments should be
interpreted with particular caution.
e computer-scored version also counts the number of items to which
the respondent has answered agree or strongly agree . Fewer than one in one
hundred cooperative volunteers agreed with more than 150 items; larger
counts can be viewed as evidence of acquiescent responding. Counts lower
than 50 are similarly viewed as evidence of nay-saying. However, these
counts are used only to caution the interpreter, not to invalidate the data,
because NEO scales are balanced, with roughly equal numbers of posi-
tively- and negatively-keyed items, and thus the net e ect of acquiescent
responding is limited.
Most conspicuously absent from the NEO inventories are validity scales
that can assess social desirability, defensiveness, faking good, or malin-
gering. ere is no question that respondents can give false responses to
the NEO items; faking studies clearly show that (Paulhus, Bruce, & Trap-
nell, 1995). In principle, high scores on a scale designed to measure good
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e NEO Inventories • 241
qualities might be a tip-o to socially desirable responding, but it might
also be an honest assessment from a person with desirable traits. Screening
out such people would be counterproductive, and controlling for scores on
such a scale might actually lower validity (McCrae et al., 1989).
In an e ort to make the NEO-PI-R more consistent with common clini-
cal practice, Schinka et al. (1997) selected NEO-PI-R items to create validity
scales to assess positive presentation management (PPM), negative presen-
tation management (NPM), and inconsistency (INC). ese scales related
in the expected way to PAI validity scales (Schinka et al., 1997) and dis-
tinguished genuine patients from students instructed to fake (Berry et al.,
2001). However, we found no evidence in support of their use in volunteer
samples (Costa & McCrae, 1997; Piedmont et al., 2000). Yang et al. (2000)
examined the correspondence of psychiatric patients’ self-reports and their
spouses’ ratings of them and found that PPM moderated cross-observer
validity for Neuroticism (N), but not for any of the other factors; NPM
showed no signi cant di erences. Morey, Quigley, and colleagues (2002)
used a multimethod design in a large clinical sample and concluded that
“attempts to correct NEO-PI-R pro les through the use of scales like PPM
or NPM are likely to decrease rather than increase validity” (p. 596). Scor-
ing for the research validity scales is available from their rst author (J. A.
Schinka), and clinicians who wish to use them may do so. However, we do
not recommend them.
In principle, no set of validity scales, however sophisticated, can guaran-
tee the accuracy of results. Imagine that a client simply decides to fool the
clinician by describing not himself or herself, but, say, John Philip Sousa.
If the client makes a conscientious attempt to describe Sousa’s personality,
there will be no evidence of malingering or positive presentation manage-
ment or random responding—yet the resulting personality pro le will be
It is ironic that people who are skeptical of substantive scales are eager
to believe that their accuracy can be detected by the use of another scale.
e fact is that clinicians are o en called upon to make life-altering deci-
sions based on fallible data, and it is not surprising that they would cling to
methods that promise guidance. Unfortunately, the evidence in support of
validity scales is weak.
What, then, should clinicians do? First, they can be aware that the evi-
dence in support of substantive scales from well-validated instruments like
the NEO inventories is strong: Most of the time, assessments from psy-
chotherapy clients will be reasonably accurate. Second, they can encour-
age honest and accurate responding by establishing rapport with the client,
explaining the purpose and utility of the assessment, assuring con den-
tiality, and perhaps promising feedback. ird, they can take note of the
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242 • Costa, Jr. and McCrae
unobtrusive validity indicators that the NEO-PI-3 o ers, such as the checks
for random responding and acquiescence, and weigh their reliance on the
data accordingly. Fourth, they can compare results from the NEO inven-
tories with other information from the client’s life, medical, and legal his-
tories, and from the behavior of the client in therapy. Fi h, they can take
advantage of the knowledge of signi cant others, who may provide a more
objective portrait of the client, using validated observer-rating forms. Sixth,
they can recognize that all assessments are tentative and subject to revision
as more information is gathered over the course of therapy.
Costa and Piedmont (2003) presented the case of Madeline G, a young
Native American woman who, a er a troubled childhood, emerged as a
successful attorney noted for defending the rights of her people. At the time
she volunteered to be a case study, she was living with a common-law hus-
band who provided ratings on Form R of the NEO-PI-R. Soon a erward,
their relationship ended, and she entered a long period of depressed a ect.
She had not reestablished a relationship three years later.
Very Low Low Average High Very High
70 60 50 40 30
Very LowLowAverageHighVery High
Tr u s t
Husband’s Rating of Madeline G
Revised NEO Personality Inventory
Figure 6.1 Revised NEO Personality Inventory
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e NEO Inventories • 243
Figure 6.1 shows Madeline G’s NEO-PI-R pro le, based on her hus-
band’s ratings of her and using combined-sex norms (i.e., comparing her
to adult men and women). Because this pro le was generated by the NEO
So ware System, the more precise factor scores are given instead of domain
scores. ere is considerable within-domain scatter, which complicates the
interpretation of factor scores. For example, most extraverts are high in E1:
Warmth, and overall, Madeline G is clearly an extravert. Yet her score on
Warmth is very low. In such cases, the facet scores provide the more accu-
rate description, and one should characterize her as an extravert who lacks
is case was selected to illustrate the interpretation of a NEO-PI-R pro le
and to show the potential utility of an observer-rating version of the instru-
ment for clinical assessment. Below are excerpts from the NEO So ware
System Interpretive Report that describe the pro le and some of its impli-
cations. e Clinical Hypotheses section is included, although normally it is
only appropriate when the individual is a client in psychotherapy. For a more
complete treatment of this case, see Costa and Piedmont (2003), who inter-
pret a joint pro le of Madeline’s self-report and her husband’s rating of her.
Note, however, that within-gender norms were used in that interpretation.
Global Description of Personality: e Five Factors
e most distinctive feature of this individual’s personality is her standing
on the factor of Agreeableness. People who score in this range are antag-
onistic and tend to be brusque or even rude in dealing with others. ey
are generally suspicious of other people and skeptical of others’ ideas and
opinions. ey can be callous in their feelings. eir attitudes are tough-
minded in most situations. ey prefer competition to cooperation, and
express hostile feelings directly with little hesitation. People might describe
them as relatively stubborn, critical, manipulative, or sel sh. (Although
antagonistic people are generally not well-liked by others, they are o en
respected for their critical independence, and their emotional toughness
and competitiveness can be assets in many social and business roles. [Recall
that Madeline G is a lawyer.])
is person is described as being high in Extraversion. Such people
enjoy the company of others and the stimulation of social interaction. ey
like parties and may be group leaders. ey have a fairly high level of energy
and tend to be cheerful and optimistic. ose who know such people would
describe them as active and sociable.
Next, consider the individual’s level of Openness. High scorers like her
are interested in experience for its own sake. ey enjoy novelty and vari-
ety. ey are sensitive to their own feelings and have a greater than average
ability to recognize the emotions of others. ey have a high appreciation of
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244 • Costa, Jr. and McCrae
beauty in art and nature. ey are willing to consider new ideas and values,
and may be somewhat unconventional in their own views. Peers rate such
people as original and curious.
is person is described as being high in Neuroticism. Individuals scor-
ing in this range are likely to experience a moderately high level of nega-
tive emotion and occasional episodes of psychological distress. ey are
somewhat sensitive and moody, and are probably dissatis ed with several
aspects of their lives. ey are rather low in self-esteem and somewhat inse-
cure. Friends and neighbors of such individuals might characterize them as
worrying or overly emotional in comparison with the average person. (It is
important to recall that Neuroticism is a dimension of normal personality,
and high Neuroticism scores in themselves do not imply that the individual
is su ering from any psychological disorder.)
Finally, the individual is rated in the low range in Conscientiousness.
Women who score in this range have a fairly low need for achievement and
tend not to organize their time well. ey usually lack self-discipline and
are disposed to put pleasure before business. ey have a relaxed attitude
toward their responsibilities and obligations. Raters describe such people as
relatively unreliable and careless.
Detailed Interpretation: Facets of N, E, O, A, and C
Each of the ve factors encompasses a number of more speci c traits, or
facets. e NEO-PI-R measures six facets in each of the ve factors. An
examination of the facet scores provides a more detailed picture of the dis-
tinctive way that these factors are seen in this person.
Neuroticism. is individual is perceived as being anxious, generally
apprehensive, and prone to worry. She o en feels frustrated, irritable, and
angry at others, but she has only the occasional periods of unhappiness
that most people experience. Embarrassment or shyness when dealing with
people, especially strangers, is o en a problem for her. She is described as
being poor at controlling her impulses and desires and she is unable to han-
dle stress well.
Extraversion. is person is rated as being somewhat formal and dis-
tant in her relationships with others, but she usually enjoys large and noisy
crowds or parties. She is seen as being forceful and dominant, preferring
to be a group leader rather than a follower. e individual is described as
having a high level of energy and likes to keep active and busy. Excitement,
stimulation, and thrills have great appeal to her, and she frequently experi-
ences strong feelings of happiness and joy.
O p e n n e s s . In experiential style, this individual is described as being
generally open. She has a vivid imagination and an active fantasy life. She is
particularly responsive to beauty as found in music, art, poetry, or nature,
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e NEO Inventories • 245
and her feelings and emotional reactions are varied and important to her.
She enjoys new and di erent activities and has a high need for variety in her
life. She has a moderate level of intellectual curiosity and she is generally
liberal in her social, political, and moral beliefs [as shown in her defense of
the rights of Native Americans].
Agreeableness. According to the rater, this person tends to be cynical,
skeptical, and suspicious, and has a low opinion of human nature. She is
described as being willing at times to atter or trick people into doing what
she wants, and she tends to put her own needs and interests before others’.
is individual can be very competitive and is ready to ght for her views
if necessary. She is described as quite proud of herself and her accomplish-
ments, and happy to take credit for them. Compared to other people, she
is hard-headed and tough-minded, and her social and political attitudes
re ect her pragmatic realism.
Conscientiousness. is individual is perceived as being reason-
ably e cient and generally sensible and rational in making decisions. She
is described as moderately neat, punctual, and well organized, but she is
sometimes less dependable and reliable and more likely to bend the rules
than she should be. She has a high aspiration level and strives for excel-
lence in whatever she does. She nds it di cult to make herself do what
she should, and tends to quit when tasks become too di cult. She is occa-
sionally hasty or impetuous and sometimes acts without considering all the
Personality Correlates: Some Possible Implications
Research has shown that the scales of the NEO-PI-R are related to a wide
variety of psychosocial variables. ese correlates suggest possible impli-
cations of the personality pro le, because individuals who score high on a
trait are also likely to score high on measures of the trait’s correlates.
e following information is intended to give a sense of how this indi-
vidual might function in a number of areas. It is not, however, a substitute
for direct measurement. If, for example, there is a primary interest in medi-
cal complaints, an inventory of medical complaints should be administered
in addition to the NEO-PI-R.
Coping and defenses. In coping with the stresses of everyday life, this
individual is described as being likely to react with ine ective responses,
such as hostile reactions toward others, self-blame, or escapist fantasies. She
is more likely than most adults to use humor and less likely to use faith in
responding to threats, losses, and challenges. In addition, she is somewhat
more likely to use positive thinking and direct action in dealing with prob-
lems. Her general defensive style can be characterized as maladaptive and
self-defeating. She is more likely to present a defensive facade of superiority
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246 • Costa, Jr. and McCrae
than to be self-sacri cing. She may use such defense mechanisms as acting
out and projection.
Somatic complaints. is individual may be somewhat oversensitive
in monitoring and responding to physical problems and illnesses. She may
sometimes exaggerate medical problems.
Psychological well-being. Although her mood and satisfaction with
various aspects of her life will vary with the circumstances, in the long
run this individual is likely to feel both joys and sorrows frequently and be
moderately happy overall. Because she is open to experience, her moods
may be more intense and varied than those of the average woman.
Cognitive processes. is individual is likely to be more complex and
di erentiated in her thoughts, values, and moral judgments than others of
her level of intelligence and education. She would also probably score higher
on measures of ego development. Because she is open to experience, this
individual is likely to perform better than average on tests of divergent think-
ing ability; that is, she can generate uent, exible, and original solutions to
many problems. She may be considered creative in her work or hobbies.
Interpersonal charac teristics. Many theories propose a circular arrange-
ment of interpersonal traits around the axes of Love and Status. Within such
systems, this person would likely be described as arrogant, calculating, gre-
garious, sociable, and especially dominant and assured. Her traits are associ-
ated with high standing on the interpersonal dimension of Status.
Needs and motives. Research in personality has identi ed a widely used
list of psychological needs. Individuals di er in the degree to which these
needs characterize their motivational structure. is individual is likely to
show high levels of the following needs: achievement, a liation, aggression,
change, dominance, exhibition (attention), play, sentience (enjoyment of
sensuous and aesthetic experiences), succorance (support and sympathy),
and understanding (intellectual stimulation). is individual is likely to show
low levels of the following needs: abasement, cognitive structure, endurance
(persistence), harm avoidance (avoiding danger), and nurturance.
Clinical Hypotheses: Axis II Disorders and Treatment Implications
e NEO-PI-R is a measure of personality traits, not psychopathology
symptoms, but it is useful in clinical practice because personality pro les
can suggest hypotheses about the disorders to which patients are prone and
their responses to various kinds of therapy. is section of the NEO-PI-R
Interpretive Report is intended for use in clinical populations only. e
hypotheses it o ers should be accepted only when they are supported by
other corroborating evidence.
Psychiatric diagnoses occur in men and women with di erent frequen-
cies, and diagnoses are given according to uniform criteria. For that reason,
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e NEO Inventories • 247
information in this section of the Interpretive Report is based on Com-
bined Sex norms.
Axis II disorders. Personality traits are most directly relevant to the
assessment of personality disorders coded on Axis II of the DSM-IV. A
patient may have a personality disorder in addition to an Axis I disorder, and
may meet criteria for more than one personality disorder. Certain diagnoses
are more common among individuals with particular personality pro les;
this section calls attention to diagnoses that are likely (or unlikely) to apply.
Borderline Personality Disorder. e most common personality dis-
order in clinical practice is Borderline, and the mean NEO-PI-R pro le of
a group of patients diagnosed as having Borderline Personality Disorder
provides a basis for evaluating the patient. Pro le agreement between the
patient and this mean pro le is higher than 90% of subjects in the norma-
tive sample, suggesting that the patient may have Borderline features or a
Borderline Personality Disorder.
Other personality disorders. Personality disorders can be conceptually
characterized by a prototypic pro le of NEO-PI-R facets that are consistent
with the de nition of the disorder and its associated features. e coe -
cient of pro le agreement can be used to assess the overall similarity of the
patient’s personality to other DSM-IV personality disorder prototypes.
e patient’s scores on N1: Anxiety, N2: Angry Hostility, E1: Warmth,
E2: Gregariousness, E6: Positive Emotions, O2: Aesthetics, O3: Feelings,
A1: Trust, A2: Straightforwardness, A4: Compliance, A5: Modesty, A6:
Tender-Mindedness, and C1: Competence suggest the possibility of a Para-
noid Personality Disorder. Paranoid Personality Disorder is rare in clinical
practice; the patient’s coe cient of pro le agreement is higher than 99% of
the subjects’ in the normative sample.
e patient’s score on N1: Anxiety, N3: Depression, N4: Self-Consciousness,
N6: Vulnerability, E1: Warmth, E2: Gregariousness, O1: Fantasy, O3: Feelings,
O5: Ideas, O6: Values, and A1: Trust suggest the possibility of a Schizotypal
Personality Disorder. e patient’s coe cient of pro le agreement is higher
than 95% of subjects’ in the normative sample.
e patient’s scores on N1: Anxiety, N2: Angry Hostility, N3: Depres-
sion, N5: Impulsiveness, E1: Warmth, E5: Excitement Seeking, A2: Straight-
forwardness, A3: Altruism, A4: Compliance, A6: Tender-Mindedness, C3:
Dutifulness, C5: Self-Discipline, and C6: Deliberation suggest the possibil-
ity of an Antisocial Personality Disorder. e patient’s coe cient of pro le
agreement is higher than 95% of subjects’ in the normative sample.
e patient’s scores on N2: Angry Hostility, N4: Self-Consciousness, N6:
Vulnerability, E1: Warmth, E2: Gregariousness, E4: Activity, E5: Excitement
Seeking, E6: Positive Emotions, O1: Fantasy, O3: Feelings, O4: Actions, O5:
Ideas, A1: Trust, A2: Straightforwardness, A3: Altruism, C1: Competence,
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248 • Costa, Jr. and McCrae
and C5: Self-Discipline suggest the possibility of a Histrionic Personality
Disorder. Histrionic Personality Disorder is relatively common in clinical
practice; the patient’s coe cient of pro le agreement is higher than 90% of
subjects’ in the normative sample.
e patient’s scores on N2: Angry Hostility, N3: Depression, N4:
Self-Consciousness, O1: Fantasy, A2: Straightforwardness, A4: Compliance,
A5: Modesty, and A6: Tender-Mindedness suggest the possibility of a Nar-
cissistic Personality Disorder. Narcissistic Personality Disorder is relatively
common in clinical practice; the patient’s coe cient of pro le agreement is
higher than 90% of the subjects’ in the normative sample.
It is unlikely that the patient has Schizoid Personality Disorder, Avoid-
ant Personality Disorder, or Dependent Personality Disorder because the
patient’s coe cients of pro le agreement are lower than 50% of the subjects’
in the normative sample.
Treatment implications. Like most individuals in psychotherapy, this
patient is high in Neuroticism. She is likely to experience a variety of nega-
tive emotions and to be distressed by many problems, and mood regulation
may be an important treatment focus. Very high Neuroticism scores are
associated with a poor prognosis and treatment goals should be appropri-
Because she is extraverted, this patient nds it easy to talk about her
problems, and enjoys interacting with others. She is likely to respond well to
forms of psychotherapy that emphasize verbal and social interactions, such
as psychoanalysis and group therapy.
is patient is open to experience, probably including the novel experi-
ence of psychotherapy. She tends to be introspective and psychologically-
minded, and will probably be willing to try a variety of psychotherapeutic
techniques. Free association, dream interpretation, and imaging techniques
are likely to be congenial. Focusing on concrete solutions to problems may
be more di cult for extremely open individuals.
e patient scores low on Agreeableness. She is therefore likely to be
skeptical and antagonistic in psychotherapy, and reluctant to establish
a treatment alliance until the therapist has demonstrated his or her skill
and knowledge. Individuals with extremely low levels of Agreeableness are
unlikely to seek treatment voluntarily, and may terminate treatment early.
Because the patient is low in Conscientiousness, she may lack the
determination to work on the task of psychotherapy. She may be late for
appointments and may have excuses for not having completed homework
assignments. Some evidence suggests that individuals low in Conscien-
tiousness have poorer treatment outcomes, and the therapist may need
to make extra e orts to motivate the patient and structure the process of
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e NEO Inventories • 249
Stability of the Pro le
Research suggests that the individual’s personality pro le is likely to be
stable throughout adulthood. Barring catastrophic stress, major illness, or
therapeutic intervention, this description will probably serve as a fair guide
even in old age.
Questions to Ponder
How much con dence would you place in this informant rating as a basis
for understanding the client and her problems? If a self-report was not
available, what steps would you take to increase your con dence? e low
Agreeableness (A) and Conscientiousness (C) scores of this client suggest
that there will be resistance to therapy. What are the client’s strengths, and
how could you use them to engage the client in psychotherapy? Which kinds
of psychotherapy would you select for Madeline G; which would you avoid?
e NEO inventories were originally developed at a time when “normal”
and “abnormal” were thought to represent categorically distinct forms of
Key Points to Remember
• e NEO inventories operationalize the scienti cally rigorous Five-Factor Model.
• e NEO-PI-R and NEO-PI-3 provide detailed information on 30 facets; the brief
NEO-FFI-3 gives an overview of the ve factors; both are suitable for ages 18
• Both self-report and observer rating versions are available, and studies show con-
vergence as well as di erent perspectives.
• e NEO-PI-3, which is more readable, is suitable for ages 12 and up.
• e NEO So ware System administers, scores, and interprets NEO inventories.
• NEO-PI-3 and NEO-PI-R facet scales predict DSM personality disorders and can
alert clinicians to likely problems in living.
• NEO inventories are used around the world in over 40 authorized translations;
they are appropriate for minority and ethnic groups in North America.
• Unlike most clinical measures, the NEO inventories avoid the use of validity
scales because their utility is suspect.
• Personality feedback can be o ered in a brief summary or in a more extended
• NEO inventories facilitate the use of informant reports as substitutes for or sup-
plements to self-reports in clinical practice.
• Assessment with the NEO-PI-R can help clinicians develop empathy, identify
strengths and weaknesses, anticipate the course of therapy, and select optimal
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250 • Costa, Jr. and McCrae
psychological functioning. As a result, the use of the NEO inventories in
clinical practice was initially a matter of some controversy (Ben-Porath &
Waller, 1992). Now, in large part because of research on the FFM, it is widely
recognized that personality traits characterize all people and that the general
traits assessed by the NEO inventories are not only relevant to but essential
for an understanding of psychological functioning in clinical populations.
e NEO-PI-R and NEO-PI-3, in particular, have become a standard part
of clinical assessment (McCrae, Harwood, & Kelly, 2011). Informant ratings
on Form R of the instrument are so far underutilized by clinicians but have
great promise as a new tool for routine assessment (Singer, 2005).
1. Author Note: Preparation of this article was also supported in part (Dr. Costa) by NIH grant
P01HL36587 from the National Heart, Lung and Blood Institute and the Behavioral Med-
icine Research Center, Duke University Medical Center, Durham, North Carolina. Paul T.
Costa, Jr., and Robert R. McCrae receive royalties from the NEO Inventories. NEO-PI-R pro-
le forms and NEO So ware System Interpretive Report reproduced by special permission
of the Publisher, Psychological Assessment Resources, Inc., 16204 North Florida Avenue,
Lutz, Florida 33549, from the Revised NEO Personality Inventory by Paul T. Costa, Jr., and
Robert R. McCrae. Copyright 1978, 1985, 1989, 1991, 1992, 2010 by Psychological Assess-
ment Resources, Inc. (PAR). Further reproduction is prohibited without permission of PAR.
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Multiple Choice Questions
1. For which population is the self-report Form S of the NEO-PI-R unsuitable?
A. Acutely depressed clients.
B. Adolescents younger than 18.
D. Demented patients.
2. Correlations between Form S and Form R of the NEO-PI-R show that
A. Cross-observer agreement is substantial but not perfect.
B. Agreement is found only in individualistic cultures, not collectivistic
cultures like China.
C. Self-reports are more attering than observer ratings.
D. Only observable traits, like Extraversion, show cross-observer agreement.
3. e NEO-PI-3 is a modi cation of the NEO-PI-R that
A. Is shorter.
B. Is more readable.
C. Assesses only the 3 clinically-relevant factors.
D. Is for use only by adolescents.
4. Which of the following is not provided by the Computer Interpretive Report?
A. A description of the client’s personality traits.
B. Clinical hypotheses about possible personality disorders.
C. DSM-IV diagnoses.
D. Indicators of protocol validity.
5. Cross-cultural studies show that
A. e FFM structure of personality is universal.
B . e NEO-PI-R must be administered in the client’s native language.
C. Americans are more introverted than Asians.
D. Scalar equivalence is lost in translation.
6. e NEO-PI-R does not have social desirability scales because
A. ey were developed by Schinka et al.
B . eir use threatens the treatment alliance.
C. ere is little evidence that they work as intended.
D . e instrument is already too long.
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256 • Costa, Jr. and McCrae
7. e observer rating Form R is especially useful
A. When the client is mentally incapacitated.
B. As a supplement to Form S.
C. When there is reason to believe self-reports would be deliberately distorted.
D. All the above.
8. Feedback on personality scores
A. Is appropriate only for normal volunteers.
B. Must be at a very broad and super cial level.
C. Can be an important part of therapy.
D. Has no role in couples therapy.
9. Research on the clinical use of the NEO Inventories shows that
A. Personality traits are related to Axis II disorders, but not Axis I disorders.
B . e NEO-PI-R adds nothing to standard clinical assessments.
C. Attention de cit/hyperactivity disorder is chie y predicted by low
D. High Conscientiousness predicts increases in manic symptoms in bipolar
10. NEO-PI-R scores are helpful to the clinician in
A. Identifying strengths as well as weaknesses.
B. Developing empathy.
C. Selecting the optimal form of treatment.
D. All the above.
1. Questionnaires like the NEO-PI-R are subject to conscious distortion and bias.
What can the clinician do to optimize the accuracy of test results when using
[Response ought to include the following: (a) validity indicators should be con-
sidered, but not necessarily used to discard protocols; (b) self-reports can be sup-
plemented by observer ratings from an informed and impartial observer; (c) the
clinician should encourage the cooperation of the client by explaining the need
for accurate assessments, ensuring con dentiality, and perhaps o ering feedback;
(d) the accuracy of all assessments should be considered and reconsidered in
light of interactions with the client and all other available information.]
2. At your rst session with a new client, the NEO-PI-R suggests that her most dis-
tinctive traits are high O and low E. How do you anticipate that your interactions
with the client will go, and what does this information suggest about the best
approaches to therapy?
[Response should include (a) it may take a few sessions for the client to warm
up to the therapist; (b) structured therapies may be preferred over open-ended
talking; (c) novel and imaginative forms of therapy may intrigue the client; (d)
depending on the speci c problems associated with low E, the client might bene-
t from assertiveness or other social skills training.]
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