 |
|
Cost effective computerized psychological testing especially for hospitals Benefits | Tests | Contact Us | Adult Test Sample | Juvenile Test Sample | Child Test Sample Psych Screen Hospital Edition Adolescent Report Ages: Adolescent 12-18 Tests available for use in Adolescent reports
REPORT CONTENTS INTELLECTUAL FUNCTIONING Vocabulary, verbal abstraction, visual problem solving, Organicity, Learning Disorder, concentrational problems, cognitive rigidity/flexibility, personality effects on cognitive style, rate of thought, obsessive ruminations, mental confusion/psychosis, delusional content VALIDITY OF TEST RESULTS Disclosiveness, symptom minimization, symptom exaggeration, consistency, response sets PROBLEM AREAS Sense of identity, intrusive thoughts of past abuse, self-critical, body image, sexual concerns, Eating Disorder symptoms, security with peers, sensitivity to social cues, delinquent tendencies, family dysfunction EMOTIONAL FUNCTIONING Levels of depression/dsythymia, anxiety, anger experience and control, repression/emotional control, impulsivity, energy level ALCOHOL AND DRUG USE Reported use, obvious and subtle characteristics, ACOA issues and social system use SOMATIC FUNCTIONING Level of somatic concerns, hypochondriasis, conversion, and somatization INTERPERSONAL FUNCTIONING Social skills, introversion/extroversion, social comfort, need for attention, need for love, independence/dependence, dominance/passivity, empathy, trust, vigilance, criticalness, family problems, school/work attitudes and behaviors SELF IMAGE Ego strength, self esteem, self image DEFENSES PERSONALITY FUNCTIONING Primary and secondary personality patterns IRRESPONSIBLE THINKING ERRORS TACTICS CRIMINAL CHARACTERISTICS Generalized delinquent tendencies, awareness of appropriate social expectations and norms, criminal attitudes/values, social maturity, authority conflicts CRIMINAL MOTIVATIONS RISK NEED ASSESSMENT NORMAL SEXUAL FUNCTIONING Sex drive, levels of sexual fantasy, fund of sexual information gender identity, is strongly discrepant and does not match stereotyped images of his gender. Body image, overall sexual satisfaction DEVIANT SEXUAL FUNCTIONING Normal sexual drives, sexual preoccupation, fund of sexual knowledge cognitive distortions and immaturity typically found among sex offenders, justification, rationalization, pathology similar to that found among child molesters, Rape behavior, exhibitionistic pathology, paraphilias, sexual dysfunctions/disabilities, motivation to seek treatment for sexual problems PRIMARY CRIMINAL RELAPSE TRIGGERS IDENTIFIED RISK FACTORS FACTORS MITIGATING RISK DIAGNOSTIC CONSIDERATIONS TREATMENT RECOMMENDATIONS IRRESPONSIBLE THINKING CORRECTIVES SUMMARY SAMPLE REPORT Name: Adolescent Sample Age: 14 Sex: M Referred By: YOU Interpret Date: 11/29/99 Test Date: 11/22/99 PSYCH SCREEN, INC. PHONE (800) 588-9412 FAX (608) 752-4314 To aid in diagnosis and treatment planning, Mr. Sample was administered a battery of psychological tests including the Problem Oriented Screening Instrument for Teenagers (POSIT), Shipley Institute of Living Scale, Matrix Reasoning subtest of the WAIS - III, Minnesota Multiphasic Personality Inventory-A, Millon Adolescent Clinical Inventory, SASSI-A, State-Trait Anger Expression Inventory, Jesness Inventory, and Derogatis Sexual Functioning Inventory. The following test findings are based on Mr. Sample's responses to a widely used standardized psychological test. As with all such tests, the validity of test results is limited by Mr. Sample's honesty and self-awareness. This report should be taken as generalized probability statements that are made without benefit of clinical interview or history. Further clinical verification is needed to assist in the interpretation of test findings in light of Mr. Sample's unique history and present circumstances. Since the MMPI-A is a complicated test with multiple scales that measure similar constructs, at times inconsistencies in test results may occur due to Mr. Sample's different elevations on similar scales. When this occurs, clinical investigation to evaluate his true status is suggested. As psychological tests were designed primarily for Diagnosis and Treatment Planning purposes, the findings below focus on problems, deficits and pathology and may de-emphasize Mr. Sample's strengths. Because of this, use without collaboration, other than for the Clinical screening purpose for which they are intended, may be misleading. This is a CONFIDENTIAL REPORT meant for qualified Mental Health, Correctional and Substance Abuse professionals. While feedback of test findings to clients is highly encouraged and should be an integral part of therapy and treatment planning, clients should not be given copies of this report, as they are likely to misunderstand report contents and their tentative nature. INTELLECTUAL FUNCTIONING: Testing indicates Bright Normal potential intellectual functioning. Verbal abstraction is in the Bright Normal range with his evidencing an above average ability to think in terms of general principles, solve logical problems, and generalize between situations. Mr. Sample's Dull Normal Vocabulary suggests mild problems with learning, motivation and/or environmental stimulation/opportunities. Given his level of verbal abstraction, Mr. Sample's relatively poor vocabulary suggests a Learning Disorder that may need evaluation if motivational and environmental causes do not exist. Significant emotional upset may be interfering with cognitive functioning. In a test of visual abstract reasoning, Mr. Sample scored in the Superior range evidencing excellent visual problem solving. Both visual and verbal abstract reasoning capacities were similar. Severe difficulties in vocabulary, given Mr. Sample's level of visual abstract reasoning, exist. This may indicate Organicity, Expressive Aphasia or learning problems that should be taken into account in diagnosis and treatment planning. Mr. Sample is not reflective or thoughtful which can limit insight and judgment. He does not try to understand the world in cognitive, rational ways. Mr. Sample's use of repression and denial may lead to a lack of cognitive processing. Mr. Sample is an emotionally oriented individual who reacts to situations based primarily on his feelings rather than on a rational analysis. Problems with verbal expression may exist. Concentration difficulties are probable with Mr. Sample being distractible, preoccupied, and inattentive. This may cause Mr. Sample to miss important cues that may reduce judgment and coping. Mr. Sample is likely to be overly abstract in his thinking due to personality factors that predispose his to overly focus on general trends and miss details. Mr. Sample does not like clear-cut situations, instead preferring ambiguity. Due to a lack of self-confidence, Mr. Sample may be indecisive and have problems with decision-making. Due to his cognitive style, Mr. Sample may have severe difficulty learning by experience and may repeatedly make the same mistakes. Mr. Sample's rate of thought may be slow to the point of cognitive inefficiency. A moderate degree of obsessive ruminations and an over focus on problems and worries can interfere with cognitive efficiency. Mr. Sample does not report subjectively experiencing cognitive inefficiency. Thinking is goal-directed and orderly without significant mental confusion. Mr. Sample reports having significant levels of psychotic-like thoughts and sensory experiences with hallucinations, delusions, ideas of reference, and strange physical experiences possible. This should be clinically examined. Mr. Sample does not report having ego alien ideas that distress his. VALIDITY OF TEST RESULTS: VALIDITY OF TESTS OF PSYCHOPATHOLOGY: In completing the MMPI-A, Mr. Sample answered almost all test questions. Mr. Sample's test response pattern indicates severe efforts to present himself in an unrealistically positive light. He denied having even common human faults to the point that test results may be invalid. His true level of problems is likely to be significantly more than what is described below, as Mr. Sample depicted himself as overly virtuous, scrupulous, conforming, and self-controlled. Such responding is either a direct attempt to "fake good" on testing or indicates a severe lack of awareness and insight. This response set may reflect the use of rigid repression, naivete, denial of unfavorable traits in order to look good, below average intelligence and/or education, strict moral principles, and/or socioeconomic/cultural deprivation. An all-false response set may also be present. Mr. Sample made significant attempts to present himself as an adequate individual who does not have problems, as a strong sophisticated "fake good" minimization of problems was evident in testing. He has difficulty acknowledging problems and is defensive. Mr. Sample's level of defensiveness makes the findings below of questionable validity as his true problems are likely to be more extensive and of higher intensity than the way Mr. Sample described himself in testing. Despite these tendencies to portray himself in a positive light, mild tendencies were also present for Mr. Sample to focus on and exaggerate pathology as a "fake bad" response set also was found. While he may deny faults to others, Mr. Sample may also subjectively focus on and exaggerate his problems. This response set may affect the validity of the following test findings, though such a response may reflect feelings of being overwhelmed by his problems, chronic atypical thought patterns, and/or a compulsive need to be frank. In the beginning of the MMPI-A, Mr. Sample mildly over emphasized pathology which would primarily elevate basic scale. Mr. Sample mildly over emphasized pathology in later portions of the MMPI-A, which would primarily increase Content and Supplementary scales. "Fake good" tendencies were moderately stronger than "fake bad" tendencies. Mr. Sample was consistent in answering test questions similarly throughout the test which enhances the probable validity of the test findings given below. VALIDITY OF PERSONALITY TEST RESULTS: Mr. Sample appeared to have read the tests and did not respond randomly. Mr. Sample was so non-disclosive in answering questions that the following test results are highly questionable. As he did not readily share information, test findings probably are a gross under representation and/or misrepresentation of true problems. Testing has a moderate "fake good" response set in which Mr. Sample answered questions in socially desirable ways and minimized pathology. This may limit the validity of the following test results, as underlying pathology may be more extensive than indicated. VALIDITY OF SUBSTANCE USE TESTS: Mr. Sample did not randomly answer questions about his substance use. Mr. Sample was normally disclosive in answering questions about substance use. Due to this, the following findings are likely to accurately reflect his pattern of substance use. Supplemental validity measures suggest significant defensiveness in responding to substance use-related items. PROBLEM AREAS: Mr. Sample was specifically asked about several areas of life functioning that often are problematic for adolescents: He has a firm sense of identity to guide his behavior. Moderate intrusive thoughts of past abuse interfere with functioning. Mr. Sample is not self-critical and because of this has difficulty realistically evaluating his behavior and profiting from his experience. Moderate to severe problems with body image are reported. Mr. Sample reports moderate concerns in the area of sexuality. Eating Disorder symptoms are not admitted to. Mr. Sample reports feeling an average level of security with his peers. Mr. Sample is mildly insensitive to important social cues. Mr. Sample admits to moderately delinquent tendencies. Moderate family dysfunction is reported. To screen for other potential problem areas, Mr. Sample completed the POSIT, a 139 item self report of problem behaviors. Posit results indicated the following areas of HIGH RISK: * PHYSICAL HEALTH PROBLEMS * FAMILY RELATIONSHIPS PROBLEMS * PEER RELATIONSHIPS PROBLEMS * EDUCATIONAL STATUS PROBLEMS * SOCIAL SKILLS PROBLEMS Posit results indicated the following areas of MIDDLE RISK: * SUBSTANCE USE PROBLEMS * MENTAL HEALTH PROBLEMS * VOCATIONAL STATUS PROBLEMS * AGGRESSIVE BEHAVIOR/DELIQUENCY PROBLEMS Posit results indicated the following areas of LOW RISK: * LEISURE/RECREATIONAL PROBLEMS The following psychological test findings should be used to clarify and elaborate POSIT results. EMOTIONAL FUNCTIONING: In testing, Mr. Sample reports significant levels of depression that may be of clinical significance. Many subjective feelings of sadness and dejection exist, as Mr. Sample feels hopeless, helpless, and discouraged. This level of depression may be due to situational factors, may indicate Dysthymia or may show an adjustment to a chronic long-term clinical Depression that the person has in part learned to live with. Mild to moderate physical symptoms/signs of depression are endorsed which are suggestive of a Major Depression. Mr. Sample denies good health and has a variety of somatic complaints. Mr. Sample's level of true depression is significantly less than what he subjectively experiences as he overly focuses on feelings. Severe subjective depression is noted with Mr. Sample being extremely despondent. Severe Dysthymic character features exist, as Mr. Sample is a pessimistic individual who looks for the worst in situations. Chronic psychological signs of depression such as lack of pleasure, negativism and feelings of helpless and hopelessness are likely. He may be very pessimistic and make many negative self-statements. No indications of present anxiety were seen in testing. Mr. Sample did not depict himself as overly sensitive to environmental pressures or stress. Mr. Sample's anxiety is in line with his subjective experience. Average levels of subjective anxiety and nervousness are reported. He reacts with anger to a normal degree. At present, Mr. Sample reports experiencing mild overall anger. Very strong subjective angry feelings are currently admitted to. Mr. Sample is now experiencing moderately above average pressures to be verbally aggressive. Average pressures to physically express anger are currently said to exist. Thus both subjective angry feelings and pressures to verbally, but not physically, act out in an angry manner exist. Present pressures to verbally express anger are significantly more than pressures to physically express anger. Chances of aggressive behavior are reduced by at least average overall EFFORTS to monitor and control the outward expression of anger. Because he makes few efforts to reduce and calm down once angry feelings are experienced, the danger of present aggression is further increased. Additionally, present aggressive behavior is significantly more likely as he admits to strong overall tendencies to act out on anger once experienced. Present levels of anger reflect longstanding anger problems. Very high levels of Trait Anger are admitted to as Mr. Sample described himself as generally experiencing severe levels of anger. He does not describe himself as being quick tempered. Mr. Sample is overly sensitive to criticism and rejection and so may perceive/exaggerate criticism and rejection where none actually exists. Feelings of rejection can provoke intense anger that may lead to further rejection. Mr. Sample reports very frequently experiencing high levels of anger in a variety of settings. His subjective experience of anger can be intense and serve as a focal point for determining behavior. How this anger is expressed depends on the anger management style described below. Once anger is consciously experienced, Mr. Sample reports making normal efforts to suppress his anger. Mr. Sample then invests little energy in calming down and remaining conscious anger. He usually experiences anger once angry feelings are evoked. Mr. Sample describes making moderate efforts to control rather than act out on anger when it is consciously experienced. Severe tendencies to act out on anger once consciously experienced are said to exist. Feelings may be expressed either verbally or behaviorally. Mr. Sample does not display tendencies to be Authoritarian and does not use his anger to intimidate others. While significant efforts to suppress, repress and/or deny anger are reported, Mr. Sample directly expresses anger once he becomes aware of it. Mr. Sample's tendency to act out on anger once it is felt is likely to be expressed as significant irritability, high levels of Trait anger and/or generalized tendencies to experience anger are reported. While generally out of touch with underlying feelings due to strong defense mechanisms, Mr. Sample is presently experiencing strong feelings that can lead to impulsive behavior with little insight or awareness. Mr. Sample does not consciously repress feelings and is emotionally spontaneous. Mr. Sample can accept and deal with his own feelings and does not see them as strange or foreign to himself. Impulse control appears adequate with his behavior generally being deliberate. Mr. Sample has the ability to think and plan before acting, though at times he may choose not to do so, especially under stress. Mr. Sample subjectively feels able to control his impulses and is not overly concerned acting out on them. Mr. Sample's reported energy level is low to the point where initiation and behavioral follow-through may suffer. He can be slow, listlessness, apathetic and lacking in drive. While he may have enough ability to accomplish goals, his lack of motivation/energy may interfere with task completion. This may lead to negative consequences that foster increased withdrawal and lack of effort. Depression, withdrawal from substances, and other medical causes of decreased energy need to be ruled out. Psychomotor hyperactivity was not described. Moderate psychomotor retardation is reported with slow speech, thought, and/or motor activity possible. ALCOHOL AND DRUG USE: The MMPI-A reveals significant addiction proneness and possible substance use. Mr. Sample tends to be extroverted, sensation seeking, and impulsive which may lead to acting out behavior including substance use. Further evaluation for possible alcohol and drug use is indicated. In this test, Mr. Sample does acknowledge having severe substance use-related symptoms and attitudes. MACI results do not indicate substance abuse. This should be clinically verified as people who are in denial of their chemical dependency, as well as individuals without such problems, may score similarly in testing. The above findings need to be interpreted in conjunction with the SASSI results given below as the SASSI was designed specifically to assess addictive tendencies even in clients with strong denial: Above average alcohol use and use-related symptoms are reported by Mr. Sample on face valid measures. Face valid indicators suggest potentially addictive levels of drug use and use-related symptoms. Mr. Sample described equal preference for alcohol and drug use. Average levels of Obvious Attributes empirically found among chemically dependent individuals exist. Severe Subtle Attributes of chemically dependent individuals were reported. This may indicate a significant lack of insight into chemical dependency problems. Strong Subtle attributes of addiction suggest a diagnosis of chemical dependency even though face valid reports of addictive use are not made. If substance abuse is clinically seen, intensive AODA treatment on an outpatient basis is indicated, if detoxification is not necessary, due to significant underlying addictive attributes. SOMATIC FUNCTIONING: Current somatic concerns on a wide variety of physical problems are reported which may indicate an over concern about his physical condition. Physical complaints (often are without a clear organic basis) are probable as Mr. Sample reports a broad range of physical symptoms that may include intake, elimination and aches and visceral pains. A history of physical symptoms, most of which are vague, and a preoccupation about bodily functioning is probable. Mr. Sample overly focuses on minor illnesses which causes more concern than would be expected in most persons. Such scores may also reflect true physical problems that need to be clinically ruled out. Symptoms may be stress-related. When physical problems exist, an exaggeration of symptoms is probable. He now feels significantly below par mentally and physically. A severe tendency for psychosomatic problems to develop under stress exists. Often these symptoms are used for secondary gain such as to avoid responsibility. When confronted on this, Mr. Sample may become hostile and feel persecuted. Repression can lead to Conversion symptoms. Level of repression makes the development of Conversion symptoms possible. Due to current low levels of stress and/or stress proneness, present stress-related somatic complaints are not probable even if overall tendencies to somatize exist. Somatic problems may be used to indirectly express anger or to manipulate others. Many secondary gains are likely as Mr. Sample uses physical complaints to vent feelings, escape responsibility and to control others with little awareness. INTERPERSONAL FUNCTIONING: Mr. Sample is an odd, peculiar and eccentric individual who lacks basic social skills. His unusual behaviors and thought patterns make it difficult for others to relate to his. Mr. Sample is introverted and tends to be more comfortable when he is alone. An attachment deficit may exist as Mr. Sample describes engaging in significant avoidance and interpersonal withdrawal. Much social withdrawal exists as he actively avoids being with others. Social withdrawal secondary to Mr. Sample's depression may occur as he may have lost interest in daily activities and have low energy. A very high level of social discomfort and anxiety exists. Mr. Sample reports average levels of social confidence. He subjectively feels an average ability to effectively relate to and deal with others. He feels exceptionally isolated and alienated from others. Mr. Sample believes that people misunderstand his and does not believe that people will help or assist his. Mr. Sample's self-centeredness and/or grandiosity severely limit his sense of empathy. Mr. Sample tends to be optimistic and positive about people. Strong needs for affection, love and intimacy are reported to the point where Mr. Sample will do almost any thing to receive love. Such needs may be difficult to fill resulting in much frustration. Codependent relationships are likely. Mr. Sample's level of suspiciousness and/or social withdraw may interfere with Mr. Sample's ability to meet his needs for love. Mr. Sample is a dominant, persistent individual who likes to take the lead in situations. He may have difficulty following others. His dependency needs are in the average range with his having the ability to both be independent and dependent as situations require. Mr. Sample has trouble developing rapport and intimacy with others, as he generally feels different, estranged and unusual. He feels misunderstood by others. A mild level of being over sensitive to and vigilant of others was described. Mr. Sample can blame others for his problems and generally sees the world as threatening and unfair. He expects others to be exceedingly untrustworthy, devious and act out for personal profit. He constantly expects others to lie, cheat, and manipulate to gain advantage. Mr. Sample can be judgmental and critical. At times Mr. Sample can be self-righteous and moralistic. He has occasional hostile feelings when others do not live up to his expectations. The significant antisocial trends reported suggest that Mr. Sample wants to do as he pleases without feeling a sense of obligation to others. He has trouble with authority and resents rules. Power and control issues are likely. Verbal threats and aggression may be used to gain other’s compliance. He may ignore social rules and do what he pleases. Mr. Sample's relationships tend to be stormy and conflictual. He has difficulty maintaining a long-term relationship. Multiple family problems are reported with Mr. Sample feeling exceptionally unloved and unsupported by his family. Dysfunctional, conflictual relationships and severe anger are probable. Mr. Sample reports having unproductive school attitudes and behaviors that may interfere with school performance and leave his feeling unable to perform at his school. Mr. Sample grossly lacks having educational and life objectives to guide his. He is not motivated to achieve which hurts performance. Frustration tolerance and persistence are extremely poor. SELF IMAGE: He is an extremely immature, self-centered individual who has poor frustration tolerance and is prone to acting out. Mr. Sample blames others for his problems and has difficulty seeing his role in setting up problems. Insight and judgment are very limited, as Mr. Sample's thinking is concrete and unelaborated. Mr. Sample feels unable to cope and withdraws into fantasy. Mr. Sample usually does not care what others think of his. He has an extremely poor self-esteem and feels unattractive and useless. Mr. Sample easily feels rejected as he projects his own feelings of being unattractive and useless. Lowered self-esteem and feelings of being incompetent, uselessness and inadequate may in part be secondary to depression. Mr. Sample feels very uncomfortable and unhappy with himself. Extreme guilt and regret are reported. Mr. Sample has a grandiose self-image and may unrealistically appraise his own abilities as being special and above others. Mr. Sample subjectively identifies himself as having as having Average levels of antisocial values and past antisocial acting out. He is not likely to be impulsive, have difficulty with authority figures and act out in defiance of social rules. He accepts authority and social standards. Mr. Sample does not justify that his ends justifies any means. He does not act opportunistically in his dealing with others. DEFENSES: * Somatization * Conversion Symptoms * Repression * Denial * Projection * Displacement * Acting out PERSONALITY FUNCTIONING: Mr. Sample's underlying Personality problems are significant and of moderate severity. The Personality problems described below are likely to be a contributing factor to other psychological problems as they interfere with Mr. Sample's ability to function productively. Testing indicates Histrionic, Narcissistic, and Antisocial features. Mr. Sample is a Criminal Thinker who, out of his needs to feel superior, is domineering, critical, and aggressive. Mr. Sample largely feels above the law and has an exaggerated sense of uniqueness and entitlement. He does whatever he pleases without thinking of social appropriateness or long-term consequences. Mr. Sample is feeling oriented and often reacts in terms of impressions without thinking through options. Relationships can be explosive and short-lived as Mr. Sample manipulates others into meeting his needs through deception and intimidation. He has a poor tolerance for frustration; frequent temper tantrums are likely. Mr. Sample often makes a poor choice in friends and spouses. A long history of erratic, superficial, and exploitive relationships is likely. He attempts to control through anger, seductive behavior and manipulation as multiple power and control issues exist. Pathological lying, deception, insincerity, and disregard for the truth are likely. Rather than dealing with problems, Mr. Sample escapes into fantasies of success, power, and admiration without taking the necessary actions to achieve these goals. Mr. Sample's thought patterns are impressionistic and scattered; therefore, he does not easily learn from experience. His responses are based more on feelings than on rational analysis as Mr. Sample lives in a nonfactual world of emotional reactions and underlying emotional conflicts. He construes situations as he wants rather than as they are and looks for magical solutions based on intuition without thinking through consequences, which results in poor judgment and self-defeating behavior. Mr. Sample acts on many repressed emotional conflicts with little awareness as repressed negative feelings can build until he overreacts dramatically to minor problems. When repression fails, Mr. Sample's exaggerated and changeable feelings can result in acting out. Mr. Sample is easily bored and may create chaos out of his excessive need for excitement and external stimulation. Criminal behavior is most likely based on active Criminal Thinking, underlying emotional conflicts, and grandiosity and entitlement. MMPI-A RESULTS INDICATE THAT IN ADDITION TO THE ABOVE PERSONALITY PATTERNS, Mr. Sample ALSO IS: Mr. Sample is a cynical, pessimistic, demanding individual who can be self-centered and complaining. Numerous somatic complaints including insomnia, pain, fatigue, GI difficulties and headaches are common with Conversion symptoms possible, as Mr. Sample tends to convert his psychological difficulties into physical problems. Despite making many somatic complaints, Mr. Sample may show inappropriate affect and act indifferent to these problems. Physical symptoms may be used in a manipulative way. He attempts to charm people into taking care of his. He feels easily defeated, does not see ways to improve his own life and is rarely satisfied. He is a passive, highly dependent individual who is psychologically naive. Insight is poor as somatization and denial keep Mr. Sample from acknowledging his emotional problems. Mr. Sample can be self-centered, childish, and immature. While extroverted and engaging in many attention-seeking behaviors, his relations with others tend to be superficial despite his strong underlying dependency needs that may be hard for Mr. Sample to fill. His behavior tends to be based more on emotional reactions than on rational analysis. He often makes poor choices in friends and spouses; most relationships are stormy and result in little real or durable attachment. He adopts a seductive, flirtatious, sexually provocative stance to seek help, not sexual gratification. He is quite manipulative and unassertive. He may be very pessimistic and have many negative self-statements. Mr. Sample is likely to be slow and cautious, and often has trouble initiating actions. A lack of persistence and follow through is to be expected. Lowered self-esteem and feelings of incompetence, uselessness and inadequacy are probable. Repressed negative feelings can build until he dramatically overreacts to minor problems. When repression fails, Mr. Sample's exaggerated and changeable feelings can result in wild acting out. Mr. Sample is easily bored and may create chaos out of his excessive need for excitement and external stimulation. SECONADARY MMPI-A SCALE ELEVATIONS FURTHIS SUGGEST THAT Mr. Sample IS: Is easily depressed and has negative thought patterns. He may be very pessimistic and make many negative self-statements. Mr. Sample is likely to be slow and cautious, with his often having trouble initiating actions. A lack of persistence and follow through is to be expected. Lowered self-esteem and feelings of incompetence, uselessness and inadequacy are likely. Is introverted, interpersonally aloof, shy and easily embarrassed in social situations. CRIMINAL CHARACTERISTICS: Mr. Sample's overall score on a Discriminant Function analysis shows mild to moderate generalized delinquent tendencies. He has moderate underlying global predisposition to break social rules and act out antisocially. Mr. Sample's level of social maladjustment is in the normal range indicating that he has an awareness of appropriate social expectations and norms. Mr. Sample displays attitudes similar to those often found among criminals in that he fears failure, enjoys taking risks, relies on chance rather than effort, wants to appear tough, and is gang-oriented. These attitudes may condone and contribute to criminal behavior. Mr. Sample is an extremely socially immature, irresponsible individual whose coping skills and social judgment are poorly developed. He unrealistically evaluates and inappropriately deals with problems. He tends to lack in insight and empathy, with little awareness of how his behavior impacts others. Mr. Sample's feelings are often repressed and can cause acting out when experienced. Mr. Sample does not report significant authority conflicts and can relate to authority figures. Mr. Sample views the world in terms of power and control and attempts to manipulate others to his own ends. Manipulation and deceit can become a way of life and are ends in themselves. Mr. Sample's conscience development is lacking as he purposely attempts to deceive and manipulate others in his efforts to control them. Testing also shows Mr. Sample has other secondary motivation(s) for acting out including: Mr. Sample has a strong negative self-image that leads his to ruminate on his problems. Tension builds until he acts out to relieve repressed feelings. Criminal behavior is often a way to deal with underlying emotional problems. SEXUAL FUNCTIONING: NORMAL SEXUAL FUNCTIONING: *PLEASE NOTE THE DSFI WAS NORMED ON ADULTS, THUS THE FOLLOWING SCORES ARE IN COMPARISON TO INDIVIDUALS OVER 18. WHILE THE FOLLOWING RESULTS ARE GIVEN FOR INFORMATIONAL PURPOSES, THE EFFECTS OF Mr. Sample's AGE AND THISEFORE LACK OF EXPERIENCE/EXPOSURE NEED TO BE TAKEN INTO ACCOUNT IN INTERPRETING THESE RESULTS. In a test of normal sexual functioning, Mr. Sample described having a very low sex drive as compared to a typical adult, which may or may not be age appropriate. Mr. Sample desires sex much less than normal for an adult. He admits to having participated in an exceptionally limited range of sexual behaviors and practices as compared to a typical adult, which may be age appropriate or indicate sexual inhibition, rigidity, or lack of interest. Extremely low levels of sexual fantasy when compared to an adult are reported. He does not admit to sexual thoughts and presents himself as asexual. While this may be age appropriate, it also could indicate a lack of interest in sex with denial and malingering needing to be ruled out. Expressed attitudes toward sex were mildly conservative, traditional and restrictive. A mild level of taboos on sexual behavior was reported. Mr. Sample's fund of sexual information is below average. He can be lacking in knowledge about sex and sexual functioning. In describing his personality, Mr. Sample reports having a strongly discrepant number of characteristics commonly associated with his gender in relation to traits thought to be common to be masculine. An exceptionally strong role definition, to the point of clinical significance, exists with Mr. Sample reporting having an exceptional amount of either stereotypically masculine or feminine attributes. Mr. Sample has an average body image and satisfaction with his body. He feels that he is normally attractive. A low average level of overall satisfaction with his sex life is reported. IDENTIFIED RISK FACTORS: Posit results indicated the following areas of HIGH RISK: * PHYSICAL HEALTH PROBLEMS * FAMILY RELATIONSHIPS PROBLEMS * PEER RELATIONSHIPS PROBLEMS * EDUCATIONAL STATUS PROBLEMS * SOCIAL SKILLS PROBLEMS Posit results indicated the following areas of MIDDLE RISK: * SUBSTANCE USE PROBLEMS * MENTAL HEALTH PROBLEMS * VOCATIONAL STATUS PROBLEMS * AGGRESSIVE BEHAVIOR/DELIQUENCY PROBLEMS * Possible Learning Disorder * Is not reflective or thoughtful which can limit insight * Concentrational difficulties are probable * Is overly abstract in his/his thinking due to personality factors * Is cognitively impulsive * Due to their cognitive style, may have difficulty profiting by experience * Extreme non-disclosure in testing * Severe "fake good" response set * Is indecisive and ambivalent * High presently experienced anger * Significant current pressure to verbally express anger * High levels of generalized anger * Severely over sensitive to criticism and rejection * Invests little energy in repressing and controlling anger * Above average energy is used to control the behavioral expression of anger * Few attempts to suppress, rather then express, anger when experienced * Severe tendencies to act out on anger once experienced * Now experiencing strong feelings that may be acted upon * Underlying personality patterns may reduce impulse control under stress * High social discomfort and anxiety * Feels exceptionally isolated and alienated * Reports excessive needs for attention * Extreme needs for love and affection exist * Is extremely dominant * Relationships tend to be conflictual * Multiple family problems are reported * School attitude and behaviors problems exist * Lacks educational and life objectives * Has poor self-esteem * Repression/over-control of feelings * Strong denial * Strong projection * Externalization of blame * Acting out as a defense * Generalized Delinquent tendencies exist * Is socially immature and irresponsible * Views the world in terms of power/control and attempts to manipulate others * Criminal behavior is often a way to deal with underlying emotional problems. * Mr. Sample reports a low level of normal sexual drives and interests * Has a poor fund of sexual knowledge VERY SEVERE CHARACTER PATHOLOGY: * Histrionic traits MILD TO MODERATE INTENSITY CHARACTER PATHOLOGY: * Schizoid traits * Avoidant traits * Narcissistic traits * Antisocial traits * Paranoid traits FACTORS MITIAGATING RISK: Posit results indicated the following areas of LOW RISK: LEISURE/RECREATIONAL PROBLEMS: * Has adequate verbal abstract reasoning * Visual abstract reasoning is adequate * Racing thoughts and flight of ideas not reported * Obsessive ruminations and worries are not reported * No mental confusion evident in testing * No "fake bad" response set * Thinking is goal-directed and logical without signs of mental confusion * No significant depression * No significant anxiety * No Significant current pressure to physically express anger * Is not overly quick tempered * Does not displays tendencies to use anger to intimidate others * Impulse control appears adequate * Energy level is low * No paranoia * Rends to be optimistic and positive about people * Dependency needs are in the average range * Does not report severe problems accepting authority and social standards * Does not feel that his ends justifies any means * Has an awareness of appropriate social expectations and norms * Does not report significant authority conflicts * Expressed attitudes toward sex were average * Body image is at least average * Overall satisfaction with his sex life is at least average DIAGNOSTIC CONSIDERATIONS: RULE OUT AXIS I: * Dysthymia * Adjustment Disorder with Depressed Mood * Intermittent Explosive Episodes * Conduct Disorder AXIS II: WHILE UNDER THE AGE OF 18, TESTING SUGGESTS THAT THE FOLLOWING PERSONALITY FACTORS MAY BE AT PLAY: Antisocial, Histrionic and Narcissistic features IN ADDITION, MMPI-A TESTING FURTHIS SUGGESTS THAT THE FOLLOWING PERSONALITY FACTORS MAY BE AT PLAY: POSSIBLE PRIMARY FEATURES: * Histrionic features POSSIBLE SECONDARY PERSONALITY PATTERNS suggested by the MMPI-A: * Schizoid features TREATMENT RECOMMENDATIONS: Based on Mr. Sample's self-report, the following corrective treatment approaches are recommended. Care should be taken to ensure that these suggestions match Mr. Sample's clinical presentation and history. If test invalidity indicators have been raised (see validity section), these recommendations may not reflect Mr. Sample's true clinical needs. DUE TO SIGNIFICANT LEVELS OF DEPRESSION REPORTED, CLINICAL INVESTIGATION OF POSSIBLE SUICIDAL IDEATION SHOULD OCCUR WITH NECESSARY INTERVENTIONS TAKEN. DUE TO SIGNIFICANT LEVELS OF AGGRESSION REPORTED, CLINICAL INVESTIGATION OF POSSIBLE HOMICIDAL IDEATION SHOULD OCCUR WITH NECESSARY INTERVENTIONS TAKEN. Mr. Sample NEEDS TO BE CHECKED MEDICALLY TO HELP DETERMINE THE EXTENT THAT HIS/HIS PHYSICAL CONCERNS ARE GENUINE. Continued communication with his physician is essential. PSYCHIATRIC REFERRAL FOR EVALUATION FOR PSYCHOTROPIC MEDICATIONS IS WARRANTED INCLUDING THE FOLLOWING TYPE(S) OF MEDICATION FOR: ANTIDEPRESSANTS ANTIANGER Due to possible learning problems, much redundancy and multisensory input should be used. Care needs to be taken so that Mr. Sample's treatment does not become a failure experience due to his learning problems. Self-esteem issues over learning deficits should be addressed in therapy. Exploration of the causes of verbal problems as compared to visual functioning should be investigated. Presentation of material in a visual format should be effective. Behavioral techniques such as discrete target behaviors and immediate consequences are suggested to teach Mr. Sample to take responsibility for his actions, as he does not connect actions with his consequences. Need for consistency and clarity are all important with Mr. Sample not allowed to talk his way out of consequences. Rationalizing and intellectualizing must be challenged as Mr. Sample needs to learn that what he does is much more important than his reasons and intentions. Mr. Sample needs to learn more direct ways to deal with his feelings and to gain attention than through somatic problems. Do not let Mr. Sample's somatic concerns lead to avoidance. Use of praise and positive reinforcement is particularly useful as Mr. Sample is more likely to change his behaviors in order to receive praise than he would be to avoid punishment. Unless negative feedback is couched in carefrontational ways, Mr. Sample will ignore and discount it as criticism. As testing indicates significant family problems, an exhaustive examination of Mr. Sample's family system is called for. Family therapy may be indicated. As social skills deficits are likely to contribute to Mr. Sample's problems, social skills training is recommended. Extensive value adjustment work is necessary as Mr. Sample lacks knowledge of normal societal conventions. He must be taught what acceptable social standards are through educational and Cognitive Behavioral approaches. Insight-oriented technique may help Mr. Sample understand and deal with troubling Family of Origin issues as much maladaptive behavior is in part based on emotional conflicts rooted in his past. Insight-oriented techniques should be used to help his resolve underlying emotional conflicts and habitual self-defeating behavior patterns. As Mr. Sample blames others for his problems, therapists should encourage his to be responsible and accountable for his actions and not allow his to fall into Victimstance. Mr. Sample needs to learn anger control techniques. It is essential that Mr. Sample not be positively reinforced for covert or overt aggression. He must become aware of the negative impact of anger on his life to increase motivation to change. Cognitive Behavioral anger control technique in conjunction with Mr. Sample being taught prosocial, less aggressive ways of meeting his needs is necessary if he is to give up violence as a coping technique. Mood stabilizing medications may be indicated if biological components to Mr. Sample's aggression are suspected. As he experiences much anger, work on how to detach from and reframe anger once it is evoked is important. As much of Mr. Sample's anger may be due to over sensitivity to criticism, a stress inoculation approach coupled with self-esteem work may prove helpful. Mr. Sample needs to put more effort into constricting angry feelings. Mr. Sample needs to put more effort into dealing with angry feelings that he experiences rather than acting out on them. Limited, careful use of emotive techniques such as psychodrama, dance, art therapy, gestalt exercises, and/or imagery may help Mr. Sample uncover underlying repressed feelings. Care must be taken that issues are resolved before Mr. Sample leaves his therapy session. Timing and rate of uncovering are all-important as flooding Mr. Sample with overwhelming feelings may lead to future resistance and/or acting out. Due to high levels of addiction evident in testing, intensive AODA treatment is needed. This may occur on an inpatient or, if detoxification is not necessary, an outpatient basis. The reason for Mr. Sample's lack of normal sexual drives and interests needs to be assessed if age in appropriate. Remedial education, social and heterosexual skill training and self-esteem work may be required to heighten attraction to appropriate sexual outlets. Stepwise positive interaction with sexually appropriate partners is indicated. If Mr. Sample's low sexual interest is due to personality factors such as a Schizoid personality disorder, it is unrealistic to expect that Mr. Sample will increase his sexual attraction to age appropriate partners. As Mr. Sample reports engaging in an extremely limited range of sexual practices, the effects of this on his sexual adjustment should be evaluated if this is not age appropriate. The clinical effects of Mr. Sample's admission to having a highly stereotyped sex role should be determined if this is causing significant emotional or life problems. Sex education is essential as Mr. Sample's lack of knowledge of sexual functioning and behavior may contribute to his sexual acting out. Variables: * POSIT * SUBSTANC - 6 PHYSICAL - 5 MENTAL_H - 8 FAMILY_R - 6 * PEER_REL - 9 EDUCATIO - 14 VOCATION - 4 SOCIAL_S - 5 * LEISURE_ - 3 AGGRESSI - 8 SHIPLEY INSTITUTE OF LIVING SCALE: * VOC - 18 AB - 32 WAIS-III MATRIX REASONING SUBTEST: * MATRIX - 13 MILLON ADOLESCENT CLINICAL INVENTORY: * V - 0 DISCLS - 22 DESIRE - 77 DBASE - 35 * INT - 72 INH - 35 DOLE - 70 SUB - 62 * DRM - 79 EGO - 74 ANT - 75 AGR - 33 * CNF - 69 OPP - 36 SDEM - 21 BRDL - 30 * ID - 50 SDEVL - 24 BDIS - 72 SEXDIS - 75 * PINSEC - 55 SOCINSEN - 66 FAMDIS - 71 CHILDAB - 77 * EATDYS - 4 AODA - 60 DELIN - 77 IMP - 34 * ANXTY - 88 DEPR - 67 SUICIDE - 55 ADOLESCENT SASSI: * FVA - 6 FVOD - 8 OAT - 9 SAT - 6 * DEF - 6 DEF2 - 6 RAP - 0 STATE-TRAIT ANGER EXPRESSION INVENTORY: * SANG - 64 SANGF - 70 SANGV - 66 SANGP - 54 * TANG - 72 TANGT - 54 TANGR - 78 AXI - 42 * AXO - 87 ACI - 23 ACO - 67 AXINDEX - 76 JESNESS INVENTORY: * SMAL - 56 VALUES - 63 IMMAT - 78 AUTISM - 58 * ALIEN - 39 ASOCIAL - 66 AA - 44 AP - 37 * CFM - 57 CFC - 56 MP - 72 NA - 66 * NX - 58 SE - 62 CI - 51 DEROGATIS SEXUAL FUNCTIONING INVENTORY: * SINF - 38 SEXP - 25 SDRIV - 32 SATT - 45 * SROLE - 34 SFANT - 30 SBODY - 52 SSATIS - 40 ADOLESCENT MULTIPHASIC SEX INVENTORY: * SOCSEX - 17 SEXOBS - 0 SEXKNOWL - 5 COGDIS - 5 * JUSTIF - 4 TRTAT - 1 CHMOL - 7 CHFANT - 4 * CHCRUISE - 1 CHASSAUL - 3 CHAG - 1 INCEST - 0 * BOY - 0 GIRL - 3 RAPE - 1 RFANT - 0 * RCRUISE - 1 RASSAUL - 0 RAG - 0 SADOMAS - 0 * EXHIB - 4 EXFANT - 0 EXCRUISE - 1 EXASSAUL - 2 * EXAD - 1 FETISH - 0 VOYER - 1 OBSCENE - 2 * BOND - 0 SADO - 0 PHYSDIS - 0 IMPOT - 0 MMPI-A VALIDITY SCALES: * QUES - 0 L - 80 F - 64 F1 - 62 * F2 - 58 K - 72 TRIN - 50 TF - 1 * VRIN - 55 MMPI-A CLINICAL SCALES: * HS - 74 D - 67 HY - 75 PD - 46 * MF - 63 PA - 62 PT - 47 SC - 58 * MA - 38 SI - 67 MMPI-A HARRIS LINGOES SUBSCALES: * D1 - 78 D2 - 65 D3 - 60 D4 - 55 * D5 - 62 HY1 - 78 HY2 - 76 HY3 - 73 * HY4 - 72 HY5 - 5 PD1 - 66 PD2 - 58 * PD3 - 44 PD4 - 68 PD5 - 78 PA1 - 63 * PA2 - 65 PA3 - 64 SC1 - 55 SC2 - 59 * SC3 - 51 SC4 - 58 SC5 - 52 SC6 - 65 * MA1 - 32 MA2 - 45 MA3 - 65 MA4 - 55 * SI1 - 68 SI2 - 72 SI3 - 58 MMPI-A SUPPLEMENTARY SCALES: * A - 45 R - 35 IMM - 75 MACR - 68 * PRO - 58 ACK - 85 MMPI-A CONTENT SCALES: * ANX - 55 OBS - 23 DEP - 78 HEA - 65 * ALN - 88 BIZ - 52 ANG - 66 CYN - 75 * CON - 55 LSE - 75 LAS - 77 SOD - 85 * FAM - 85 SCH - 73 TRT - 35 * SEX - M |
|