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Name: John Sample Age: 12 Sex: M Referred By: 4/18/90 Interpret Date: 5/9/02 Test Date: 5/6/02 PHONE AND FAX (800) 588-9412 TRAUMATIC SYMPTOM CHECKLIST FOR CHILDREN- REPORT To aid in diagnosis and treatment planning, Mr. Sample was administered the Traumatic Symptom Checklist For Children. 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. The report below 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 de-emphasize Mr. Sample's strengths. Because of this, use without collaboration, other than for the clinical screening purposes, for which they are 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 probable to misunderstand report contents and their tentative nature. PTSD specific testing did not have a "fake good" response set, with Mr. Sample not minimizing his problems and pathology. A mild "fake bad" response set exists in which Mr. Sample may have mildly focused on his problems. The following test findings may be a mild over representation of Mr. Sample's symptoms/problems. An extreme level of overall current PTSD symptoms is reported. This may include the reliving of traumatic experiences (intrusive flashbacks and dreams), avoidance of stimuli and feelings associated with the traumatic event, and hyper-arousal (high energy, hyper-vigilance and startle reactions). Mr. Sample described presently experiencing very severe dissociation including derealization, depersonalization, and detachment that leaves him distracted, shutdown, and/or numb. This dissociation very strongly follows a classic pattern often found in PTSD and reduces Mr. Sample's sensitivity to what is happening around him. Dissociation may be a way for Mr. Sample to avoid negative feelings or intrusive events and can reduce his ability to effectively cope with his environment. Mr. Sample also described a moderate degree of daydreaming/escaping into fantasy. Very severe overall concerns with sexuality were present in testing. A very severe preoccupation with sexuality and/or a heightened, developmentally inappropriate, level of sexual behavior were described by Mr. Sample. Significant distress with issues of sexuality was was seen in testing that is likely to indicate fears about sex, the presence of unwanted sexual thoughts/feelings, and/or participation in anxiety, possibly nonconsensual, causing sexual behavior. Very severe anxiety is seen in testing that may indicate significant autonomic over arousal (sleep difficulties, irritability, hyper alertness and vigilance, and startle responses) that could be associated with PTSD. Mr. Sample reports severe depression with excessive sadness, feelings of hopelessness and helplessness, and risk for self-injury probable. Testing does not indicate undo amounts of anger. RULE OUT Post Traumatic Stress Disorder Sexual Abuse Dissociative Disorder Generalized Anxiety Disorder Adjustment Disorder with Anxious mood Major Depression Adjustment Disorder with Depressed mood RECOMMENDATIONS Acute treatment for PSTD/ASD is indicated. Use of EMDR should be evaluated. Evaluation of possible sexual abuse is indicated. If found, specific treatment for sexual abuse is indicated. As significant levels if dissociation are reported, this is likely to become a major therapeutic issue. Testing indicates a need for treatment of depression. Stress management procedures and/or medications are indicated to reduce Mr. Sample's level of autonomic arousal. Variables: Traumatic Symptom Checklist for Children UND - 55 HYP - 62 ANX - 77 DEP - 71 ANG - 34 PTS - 78 DIS - 78 DISO - 82 DISF - 67 SC - 88 SCP - 82 SCD - 72 SEX - M |
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