MMPI-2: In testing, Mr. Sample did not appear to defensively deny having common human faults and weaknesses and was willing to indicate his shortcomings. He showed a lack of defensiveness in testing and made few attempts to portray himself in a positive light. In taking the test, Mr. Sample appears to have grossly focused on and over emphasized pathology, presenting himself in an unfavorably negative light. Testing shows a moderate to strongly inconsistent response pattern in which Mr. Sample answered questions with similar content in different ways.

PAI: Test validity scales did not show signs that Mr. Sample answered test questions in random ways. A mild "fake good" minimization of problems was evident in testing. In taking the test, Mr. Sample appears to have grossly focused on and over emphasized pathology, presenting himself in an unfavorably negative light. Mr. Sample was consistent in answering test questions similarly throughout the test, which enhances the probable validity of the test findings given below.

MCMI-III: He was so unusually open in sharing his thoughts and feelings that this may lead to a moderate exaggeration of his true symptom picture. Test findings showed both a moderate "fake good" and a severe "fake bad" response set indicating that the following self-description is of limited validity. While Mr. Sample attempted to present himself in a socially desirable light, validity scales indicated that he also exaggerated pathology. While Mr. Sample wishes to hide problems from others, he himself may subjectively catastrophize, dwell upon and exaggerate his problems.

SASSI-3: Mr. Sample did not appear to have randomly answered questions about his substance use. Mr. Sample had a generalized tendency to be normally disclosive in answering questions and may have accurately answered test questions. Supplemental addiction measures show significant defensiveness in responding to specific use-related items.

LEVEL OF FUNCTIONING: His current verbal abstract reasoning is in the Bright Normal range. Mr. Sample's vocabulary is in the Bright Normal range. Verbal Abstraction is intact and IQ appropriate. Tests do not indicate Brain Damage. In a test of visual abstract reasoning, Mr. Sample scored in the Bright Normal range indicating above average visual problem solving. His vocabulary was congruent with his level of visual abstraction. Both visual and verbal abstract reasoning capacity were similar.

COGNITIVE PROCESSING STYLE: Mr. Sample is not reflective or thoughtful which can limit insight and judgment. 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 on his feelings rather than on rational analysis. Concentration difficulties are probable with Mr. Sample being distractible, preoccupied, and inattentive which may cause Mr. Sample to miss important environmental cues leading to decreased judgment and coping. He is an extremely cognitively rigid individual who has fixed ideas from which he has trouble deviating. Mr. Sample is likely to be ambivalent to the point where problem solving and judgment are adversely affected. Mr. Sample may show poor planning, as he is severely cognitively impulsive. Due to his cognitive style, Mr. Sample may have severe difficulty learning from his experiences and may repeatedly make the same mistakes.

MENTAL STATUS: Moderate levels of racing thoughts and flight of ideas may be occurring. Severe obsessive ruminations and worries are reported that are very likely to disrupt Mr. Sample's cognitive efficiency. Mr. Sample reports severe feelings of mental dullness. Significant Schizotypal features were evident in testing. PAI and MMPI-2 measures of overall mental confusion and psychotic symptoms were in agreement. Testing indicates strong mental confusion that may interfere with reality testing and judgment, as Mr. Sample presently has difficulty with logical goal-directed thought. Mr. Sample described his thinking as very scattered, vague, disorganized, illogical, atypical and/or unrealistic. Excessive fantasy may be used to escape reality. In the MMPI-2, Mr. Sample reported that he has extremely atypical thoughts and sensory experiences to a degree that may indicate psychosis. Mr. Sample feels as if he is losing control over his thinking, as severe ego alien ideas exist. PAI findings indicate possible low-grade hallucinatory-like experiences. A significant amount of Mr. Sample's mental confusion and poor judgment may be secondary to emotional problems disrupting his thinking and judgment.

PERCEIVED LIFE STRESS, RESOURCES AND SUPPORT: Mr. Sample described a severe amount of present stress. He reports having few supportive people in his present life to help him deal with problems and reduce his stress level. Mr. Sample is very unmotivated to seek out psychotherapy, and sees psychological interventions as unlikely to help him.

DEPRESSION: MMPI-2 overall depression scores were higher than PAI depression scores by between 1 and 1.5 standard deviations. Testing shows severe levels of depression that need further mental health treatment if they are clinically present and are not due to substance use, withdrawal, or malingering. Mr. Sample experiences severe cognitive symptoms of depression including thoughts of hopelessness, helplessness and failure that can adversely affect self-esteem and judgment. Severe physical symptoms/signs of depression are endorsed which indicate a Major Depression. Mr. Sample's level of true depression may be 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 probable.

ANXIETY: PAI and MMPI-2 scales measuring overall anxiety were in agreement. Such severe levels of anxiety are reported that Generalized Anxiety Disorder, Panic Attacks, Phobias, ADHD, Mania and PTSD need to be clinically ruled out. Mr. Sample reports being so nervous that he has trouble dealing with everyday stress, pressure, and demands. Levels of anxiety reported are likely to interfere with coping skills, increase impulsivity and lead to aversive consequences that can produce more anxiety. Severe levels of worry were described, as Mr. Sample is an over-ruminative worrier. Significant autonomic over-arousal is said to occur that may lead to physical problems and increase hyperactivity and impulsivity. Mr. Sample's level of anxiety is significantly less than what he subjectively experiences as he focuses on anxious feelings. Severe subjective feelings of anxiety were described, with Mr. Sample feeling easily overwhelmed.

ANXIETY RELATED DISORDERS: Testing shows severe phobias and/or tendencies to develop phobias. An exceptionally high level of generalized fear is reported, as Mr. Sample is easily scared and reacts with fear to a wide variety of situations. Mr. Sample has multiple specific fears that might lead to avoidance behavior. Significant Obsessive Compulsive Disorder symptoms were endorsed to the point of possible clinical significance. Mr. Sample is a very rigid inflexible individual who adheres to fixed behavior patterns to an unproductive degree. He often overly focuses on details and misses general principles. Change and novelty are very likely to cause anxiety.

In the DAP, Mr. Sample reports having been exposed to a moderately above range of traumatic events. Mr. Sample admits to exposure to the following type of traumatizing situations: childhood physical abuse, received serious threats that someone would harm him, witnessed an assault(s) on others, was sexually assaulted, saw other unspecified traumatic events that would cause fear of injury or death. The last index traumatic event was reported to have occurred in the last month. At the time of the traumatic event(s), Mr. Sample reports experiencing very severe levels of psychological distress. An average amount of dissociation was said to have occurred during the trauma.

DAP results indicate that Mr. Sample's overall present PTSD symptomatology is in the Severe range. This includes severe reexperiencing/reliving of traumatic experiences, moderate avoidance of trauma associated stimuli, feelings and thoughts, and severe autonomic over arousal. Mr. Sample does not describe presently experiencing dissociation. Mr. Sample reports severe present impairments/problems in his daily functioning as a result of his PTSD symptoms. Very severe Post Traumatic Stress Disorder symptoms were endorsed. His PTSD symptoms are probably very disruptive to Mr. Sample's day to day functioning.

ANGER: Severe anger is reported with Mr. Sample being a hostile individual whom is easily provoked. He is likely to use threats and physical intimidation to gain his ends. Moderate levels of subjective angry feelings are currently admitted to. Mr. Sample is now experiencing average pressures to be verbally aggressive. He admits to an average generalized tendency to verbally express anger. Average pressures to physically express anger are currently said to exist. This is coupled with average overall generalized tendencies to physically express anger. Present current pressures to express anger physically and verbally are equal. Mr. Sample reports having equivalent levels of generalized long-term tendencies to verbally and physically express anger. It is significant that while present subjective angry feelings are reported, Mr. Sample does not admit to experiencing pressures to act out in an angry manner. Present low levels of anger reflect typical longstanding patterns. An above average level of Trait Anger is admitted to with Mr. Sample presenting himself as generally experiencing mild levels of anger. He does not describe himself as being quick tempered. Mr. Sample displays an average sensitivity to other's criticism and rejection. Perceived disapproval does not appear to be a key source of anger. Once anger is consciously experienced, Mr. Sample reports making normal efforts to suppress his anger. An extreme amount of energy is then invested in calming down and reducing remaining conscious anger, which may result in emotional and behavioral constriction and avoidance. Despite making significant efforts to lessen anger, a significant level of anger is still experienced by Mr. Sample. Mr. Sample describes making average efforts to control acting out on anger when anger is consciously experienced. Average tendencies to express anger behaviorally once it is consciously experienced are said to exist with him not overly acting on angry feelings. His significant efforts to repress, suppress and/or deny anger are coupled with an ability to not act on anger once it reaches awareness. Mr. Sample's tendency not to act out on anger is important as significant irritability, high levels of Trait anger and/or general tendencies to experience angry feelings are reported and would otherwise result in direct anger expression.

EMOTIONAL SENSITIVITY/IMPULSE CONTROL: Mr. Sample is an extremely emotionally sensitive, high-strung individual who experiences many intense feelings. 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. He has average tendencies to consciously repress feelings once they are experienced. Mr. Sample may have atypical, unusual feelings or have feelings that are inappropriate to the situation. Alternately, at times Mr. Sample may become overly detached and alienated from his feelings and be emotionally flat. Mr. Sample has severe problems dealing with his own feelings and is now often experiencing them as strange and alien to himself. Impulse control is poor with Mr. Sample impulsively acting out directly on feelings to gain immediate gratification with little forethought of consequences or alternate courses of action. Impulsivity may lead to self-defeating behavior. Mr. Sample subjectively experiences a significant lack of control over his impulses.

ENERGY LEVEL: PAI scales measuring overall mania were significantly higher than MMPI-2 mania scales, with the tests differing by more than 1.5 standard deviations. Mr. Sample's reported energy level is significantly raised. Psychomotor hyperactivity was not described. Moderate psychomotor retardation is reported. Mildly above average levels of sensation-seeking behaviors were described. A severe lack of subjective drive and ambition is reported.

MMPI-2: MMPI testing reveals moderate addiction proneness and possible substance use.

PAI: Mr. Sample reports moderate, but significant, indications of characteristics typically found among drug-dependent individuals in the PAI. Test findings do not indicate characteristics similar to those found among alcohol-dependent individuals. Mr. Sample indicates a preference for drug over alcohol use.

MCMI: Mr. Sample expresses a preference for alcohol over drug use.

SASSI-3: Non-abusive use of alcohol is reported on face valid measures. Face valid measures do not indicate addictive levels of drug use. Significant Obvious Attributes of chemically dependent individuals exist. Subtle Attributes that are empirically found among chemically dependent individuals were not apparent in testing. Mr. Sample indicates that he has been involved in a family or social system where severe levels of substance use have occurred. Test scores indicate a low level of codependency, as Mr. Sample is likely to focus on his own needs. Despite his level of reported substance use, Mr. Sample's level of involvement in social systems where extensive substance use exists indicate a high chance of addiction.

SOMATIC FUNCTIONING: Severe current concerns about a wide variety of physical problems is reported which may indicate that Mr. Sample is over concerned about and fixated on his health. Mr. Sample reports severe GI symptoms in testing. Significant neurological problems were described. Severe Hypochondriac complaints (often without a clear organic basis) are probable. Mr. Sample now feels extremely below par mentally and physically. A moderate tendency for psychosomatic problems to develop under stress exists. A severe tendency for conversion symptoms to develop exists. Even though Mr. Sample displays tendencies to somatize, current severe levels of stresses and/or stress proneness can cause legitimate stress-related somatic problems to develop including cardiovascular and gastric symptoms. Somatic problems may be used to indirectly express anger or to manipulate others. Many secondary gains are probable.

INTERPERSONAL STYLE: Mr. Sample is an odd, peculiar and eccentric individual who lacks basic social skills. Mr. Sample is an extremely introverted individual. Social withdrawal secondary to Mr. Sample's depression may occur. A very high level of social discomfort and anxiety exists. He reports having severe doubts over his ability to deal with and relate to others. Mr. Sample almost entirely lacks a sense of empathy. Extreme needs for love and affection exist. Mr. Sample reports that he acts in an interpersonally cold and unloving way. 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 extremely passive and submissive. Mr. Sample voices an extreme need to be dependent on others. Codependency issues are paramount. Mr. Sample generally feels different, estranged and unusual. He often feels extremely misunderstood by others.

PARANOIA: MMPI-2 scales measuring paranoid symptoms were significantly higher than similar PAI scales, with the tests differing by more than 1.5 standard deviations. An extreme degree of interpersonal suspiciousness was described. Mr. Sample is extremely vigilant and constantly monitors his environment as he expects others are out to harm him. Mr. Sample projects blame for his problems, sees the world as threatening, and feels that he is unfairly treated. Marked feelings of prosecution are probable. He expects others to be exceedingly untrustworthy, devious and likely to act out for personal profit. When Mr. Sample feels slighted, he feels resentment to an average degree. He is a very self-righteous, moralistic, individual.

ANTISOCIAL TENDENCIES: PAI and MMPI-2 measurements of antisocial tendencies were in agreement. He often blatantly ignores social rules and conventions and does what he pleases, as the severe antisocial trends reported in testing suggest that Mr. Sample acts without feeling a sense of obligation or responsibility to others. He has marked trouble with authority, resents rules and is quite rebellious. Power and control issues may exist with Mr. Sample wanting others to do what ever he pleases. Mr. Sample may not act in a responsible manner.

RELATIONSHIPS: Mr. Sample's relationships tend to be stormy and conflictual. He has difficulty maintaining a long-term relationship. A moderate amount of family problems were reported. Many social problems are reported, with Mr. Sample feeling largely unloved and unsupported. Severe problems with Mr. Sample's current work attitudes and behaviors exist. An average focus on work was described.

IDENTITY: Mr. Sample lacks a stable sense of identity and generally feels unsure about what he wants from life. Mr. Sample lacks an internal compass and has difficulty knowing what he wants to do in situations. Mr. Sample feels so unable to cope that he withdraws into fantasy. He is extremely self critical, focuses on negative and has difficulty acknowledging the positive in himself.

SELF-ESTEEM: Mr. Sample feels very uncomfortable and unhappy with himself. Extreme guilt and regret are reported. Mr. Sample has an extremely poor self-esteem and feels unattractive and useless. Lowered self-esteem may in part be secondary to depression.

GENDER IDENTITY: Mr. Sample describes himself as having average levels of characteristics that are stereotypically feminine and denies having any stereotypically masculine qualities. Mr. Sample's repertoire of behaviors is in the average range with him acknowledging having average levels of feminine characteristics.

Mr. Sample's testing indicates very severe character pathology. He has deeply ingrained dysfunctional personality patterns that are probable 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 significant Avoidant, Dependent, and Passive-Aggressive features that are likely to effect daily functioning. Of these, Dependent and Avoidant features are predominant and should be emphasized in the description given below.

Although Mr. Sample has many unmet dependency needs and wants others to take care of him, he projects his low self-esteem and sees others as critical and rejecting. Mr. Sample sets bounds passive-aggressively as he is afraid to express his anger and frustration directly. Because of feeling incapable of doing things, he sets boundaries through frustrating demands by being inefficient, stubborn, and incompetent. Mr. Sample may focus his interpersonal needs on one or two others, with whom he is likely to have dysfunctional relationships. Anxiety and anger are his primary feelings.

Mr. Sample reports being unduly dependent on others and does not independently pursue his own needs. Because he expects not to be loved, he is sensitive to rejection, offense, and humiliation leaving him uncomfortable, withdrawn, lonely, and shy. Mr. Sample focuses on problems without seeing positives and blames others for his difficulties. Exaggerated help-seeking behaviors can occur.

Obsessive thoughts, over reliance on analytical thinking, and over personalization of events are common.

Even though Mr. Sample denies most of his emotions, he is often irritable and malcontent as he expresses his underlying anger through subtle attacks, blame, insults, and complaints. Underlying worry and anger can result in mood swings and tantrums. Emotional reactions especially occur when issues of separation or abandonment are present.

Maladaptive behavior may result from rebelliousness, avoidant behavior, and/or following peers.