 |
|
Name: Adolescent Sample Age: 14 Sex: M Referred By: You Interpret Date: 10/30/99 Test Date: 10/30/99 PHONE (800) 588-9412 FAX (608) 756-5840 LEVEL OF SERVICES INVENTORY-REVISED REPORT To aid in diagnosis and treatment planning, Mr. Sample was administered the Millon Adolescent Clinical Inventory. The following test findings are based on Mr. Sample's responses to widely used standardized psychological tests. 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. 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 purposes for which they were intended, may be misleading. The following 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 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. Such low levels of cognitive mediation and thought are reported that Mr. Sample may have significant problems with judgment as he may not think through problems. 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. Mr. Sample is likely to be overly abstract in his thinking due to personality factors that predispose him to overly focus on general trends and miss details. Due to a lack of self-confidence, Mr. Sample may be indecisive and have problems with decision-making. VALIDITY OF TEST RESULTS Mr. Sample appeared to have read the tests and did not respond randomly. He was normally disclosive in answering questions and sharing thoughts and feelings. Testing appears to be valid with Mr. Sample neither significantly minimizing nor exaggerating his symptoms and problems. PROBLEM AREAS Mr. Sample was specifically asked about several areas of life functioning that often are problematic for adolescents: Mr. Sample reports mild levels of suicidal ideation which need to be clinically evaluated. Intervention to deal with suicidal ideation may be warranted. He reports having moderate problems with having a stable sense of identity that guide his behavior. This may lead Mr. Sample to often act out in an inconsistent situational manner. Moderate intrusive thoughts of past abuse interfere with functioning. He is excessively self critical to the point of creating self-fulfilling prophesies. Body Image is extremely poor with Mr. Sample disliking his appearance. Moderate concerns in the area of sexuality are reported by Mr. Sample. Moderate Eating Disorder symptoms are admitted to which need evaluation. Mr. Sample reports mild insecurity about peer relations. Mr. Sample admits to being very sensitive to social cues. Mr. Sample admits to mild delinquent tendencies. Extreme family dysfunction is reported. EMOTIONAL FUNCTIONING In testing, Mr. Sample reports mild signs of depression that may be of clinical significance. Many subjective feelings of sadness, ahedonia and dejection exist which may be chronic in nature. A chronic Dysthymic, "poor me" Victim stance exists with Mr. Sample being overly pessimistic, negative, and adopting a martyr-like role. Mild levels of anxiety are reported in testing. Mr. Sample can become upset and overreact to stresses. His level of worry and apprehension may interfere with judgment and contribute to impulsive acting out. Mild to moderate levels of present anger are reported as Mr. Sample can become annoyed and provoked by situational factors. Mr. Sample has few guards against his feelings once evoked and experiences them directly as Mr. Sample appears to lack the defenses necessary to blunt the impact of anxiety, depression, and anger. This may lead to rapid mood shifts and explosive acting out. Impulse control appears adequate with 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. Underlying personality patterns may reduce Impulse control under stress or in certain select situations. ALCOHOL AND DRUG USE MACI results indicate severe characteristics similar to those found among individuals who are substance-dependent. SOMATIC FUNCTIONING A strong tendency for psychosomatic problems to develop under stress exists. These symptoms can be used for secondary gain such as to avoid responsibility. When confronted on this, Mr. Sample may become hostile and feel persecuted. Level of repression makes the development of Conversion symptoms possible. Current high levels of stresses and/or stress proneness can cause legitimate stress-related somatic complaints to develop including cardiovascular and gastric symptoms. 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 mildly introverted and tends to be more comfortable when alone. A moderate degree of interpersonal avoidance and withdrawal was described by Mr. Sample. Social withdrawal secondary to Mr. Sample's depression may occur as he may have lost interest in daily activities and have low energy. Mr. Sample reports mild interpersonal anxiety and discomfort. Mr. Sample is not overly self-centered or grandiose and can feel empathy. Mr. Sample tends to be optimistic and positive about people. Mr. Sample reports having high needs for attention. He wants attention to the point where he may act out to gain attention. His needs for attention may be difficult for Mr. Sample to fill. Mr. Sample reports having an exceptionally low need for attention. He may actively avoid recognition. 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 is able to be assertive while at the same time follow others. He is neither overly dominant nor submissive and can adapt his level of dominance to situational needs. A strong need to be dependent on others exists with Codependency issues prominent. Mr. Sample feels he has an above average ability to develop rapport and intimacy because Mr. Sample believes that he is like others. A mild level of being over sensitive to and vigilant of others was described. He feels that others are somewhat untrustworthy and may manipulate him to gain their goals. Mr. Sample is not judgmental and critical. Mr. Sample is not self-righteous and moralistic. He usually does not expect others to meet his standards. At times, Mr. Sample may ignore social rules. 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. SELF IMAGE Mr. Sample feels an average ability to cope with his problems without withdrawing into fantasy. Mr. Sample may under rate his importance as he appraises his own abilities as being well below average. DEFENSES Repression Suppression Sublimation PERSONALITY FUNCTIONING Testing indicates very severe Basic Character pathology. He has deeply ingrained dysfunctional personality patterns that are likely to cause interpersonal and intrapsychic problems. These patterns must be taken into account in diagnosing and treating other psychological problems (Axis I Disorders). Testing indicates Histrionic, Dependent, and Passive-Aggressive features. While Mr. Sample has low self-esteem and depends on others to solve his problems and make his decisions, he is also a contrary negativist person who refuses demands and indirectly controls others through manipulatively frustrating demands by being inefficient, stubborn, and incompetent. Mr. Sample often seeks attention because of unresolved dependency needs. His excessive longing for love and fear of being hurt lead to a need to control people and situations. He adopts a flirtatious, sexually provocative stance to seek help, not for sexual gratification. Mr. Sample views human relationships as conflictual and uses faultfinding as a defense against intimacy and commitment. Mr. Sample focuses on problems without seeing positives and blames others for his difficulties. He tends to form relationships with dominant, predatory partners who take advantage of him. Multiple power and control issues trouble relationships. Mr. Sample's thought patterns are impressionistic and scattered; therefore, he does not easily learn from experience. Mr. Sample's repressive style causes him to be unreflective and lacking in sharpness. 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 and looks for magical solutions based on intuition without thinking through the possible repercussions. Mr. Sample accepts only positive feelings out of fear that negative emotions will cause hurt and rejection. However, underlying depression, anxiety, and anger coexist as Mr. Sample often believes that he "got a raw deal from life." Anger is expressed through subtle attacks, blame, insults, and complaints. Repressed negative feelings can build until he overreacts dramatically to minor problems with little awareness. When repression fails, Mr. Sample's exaggerated and changeable feelings result in acting out. Emotional reactions are especially likely when issues of separation or abandonment are present. Maladaptive behavior is most likely based on Mr. Sample's dependency needs, other underlying emotional conflicts, and/or rebelliousness. DIAGNOSTIC CONSIDERATIONS RULE OUT AXIS I Dysthymia Oppositional Disorder AXIS II WHILE UNDER THE AGE OF 18, TESTING SUGGESTS THAT THE FOLLOWING PERSONALITY FACTORS MAY BE AT PLAY: Passive Aggressive, Dependent and Histrionic 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. Power struggles are to be avoided with consequences given in a matter-of-fact way. Therapists should not accept excuses and rationalizations as Mr. Sample needs to realize that his rebelliousness and "yes but" behavior is self-defeating. Underlying issues of anger and control must be brought directly to the surface and dealt with. A Cognitive Behavioral Criminal Thinking approach is primary as Mr. Sample must alter his Criminal Thought patterns if he is to act prosocially. A kind, but firm approach is indicated as therapists must support Mr. Sample while also holding him accountable. Mr. Sample is most likely to change if he sees therapists as supportive, yet at the same time demanding change. In addition to changing thinking patterns, Mr. Sample must improve his underlying self-esteem and social skills. 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. A Social Learning component is suggested as Mr. Sample must learn positive, prosocial skills to replace current maladaptive patterns. Mr. Sample now relies on maladaptive tactics to meet his needs with him having few alternative prosocial coping skills. Referral for education, volunteer work, job training, etc. should occur once Mr. Sample develops the social and cognitive skills necessary to be successful. Due to his level of dependency, rebelliousness, and/or need for attention, Mr. Sample is most likely to respond to peer feedback. 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 him resolve underlying emotional conflicts and habitual self-defeating behavior patterns. Significant environmental support and external structure are vital as Mr. Sample needs external restraints to deter maladaptive behavior. Liaison between Mr. Sample's probation/parole officer, family, AA sponsor, and/or employer is essential. As Mr. Sample blames others for his problems, therapists should encourage him to be responsible and accountable for his actions and not allow him to fall into Victimstance. Mr. Sample feels unattractive and dislikes his physical development. Therapists needs to assist him to realistically re-evaluate his physical self and to increase physical acceptance by increased hygiene, learning positive weight control techniques, and dress/beauty tips. It is likely that Mr. Sample is overly self-critical and has self-esteem problems. Therapists should encourage Self-esteem enhancement through the development of mastery skills and positive behavior. As Mr. Sample reports significant characteristics similar to those found among individuals who are substance dependent, further assessment and treatment for substance abuse may be indicated. Variables: MILLON ADOLESCENT CLINICAL INVENTORY: V - 0 DISCLS - 66 DESIRE - 59 DBASE - 52 INT - 42 INH - 65 DOLE - 77 SUB - 82 DRM - 75 EGO - 22 ANT - 62 AGR - 67 CNF - 22 OPP - 88 SDEM - 36 BRDL - 62 ID - 71 SDEVL - 86 BDIS - 88 SEXDIS - 72 PINSEC - 69 SOCINSEN - 22 FAMDIS - 81 CHILDAB - 71 EATDYS - 76 AODA - 85 DELIN - 66 IMP - 77 ANXTY - 65 DEPR - 71 SUICIDE - 62 SEX - M |
|