VALIDITY OF TESTS OF PSYCHOPATHOLOGY: In testing, Mr. Sample did not appear to defensively deny having common human faults 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. Testing shows a strong "fake bad" response set in which Mr. Sample exaggerated and distorted his problems. Mr. Sample was consistent in answering test questions.

VALIDITY OF PERSONALITY TEST RESULTS: Mr. Sample appeared to have read the tests and did not respond randomly. He was very unusually open in answering test questions, with this probably resulting in an over reporting of symptoms. Testing shows a strong "fake bad" response set in which Mr. Sample overly exaggerated and distorted his problems.

VALIDITY OF SUBSTANCE USE TESTS: Mr. Sample was overly disclosive in answering questions about substance use. As a result, the following findings are likely to be an over representation of his pattern of substance use. Supplemental validity measures suggest a lack of defensiveness in responding to specific substance use related items.

PTSD SPECIFIC TEST VALIDITY (TSCC): PTSD specific testing has a moderate "fake good" response set. Mr. Sample did not exaggerate his problems in testing.

LEVEL OF FUNCTIONING: Testing indicates Superior potential intellectual functioning. Verbal abstract reasoning is in the Superior range. Mr. Sample’s Normal Vocabulary indicates at least an average learning ability. Mr. Sample's relatively poor vocabulary given his level of current verbal abstraction suggests a Learning Disorder. Significant emotional upset may be interfering with cognitive functioning. In a test of visual abstract reasoning, Mr. Sample scored in the Dull Normal range. His vocabulary was congruent with his level of visual abstraction. Severe problems with visual abstract reasoning given his level of verbal abstraction are found.

COGNITIVE PROCESSING STYLE: Mr. Sample is not reflective or thoughtful. Such low levels of cognitive mediation and thought are reported that Mr. Sample may have significant problems with judgment. Concentration difficulties are probable. Mr. Sample may be indecisive and have problems with decision-making. Mr. Sample is moderately cognitively impulsive. Due to his cognitive style, Mr. Sample may have problems learning from experience and can repeatedly make the same mistakes.

MENTAL STATUS: Significant obsessive ruminations, brooding over problems and worries are reported. Thinking is goal-directed and orderly. Unusual thoughts and sensory experiences are not reported.

PROBLEM AREAS: Mild levels of suicidal ideation need to be clinically evaluated. He reports lacking a stable sense of identity that guides behavior. Because of this, Mr. Sample is easily influenced by situational factors and so can be extremely erratic and unpredictable in his actions. He reports occasional mild intrusive thoughts of past abuse. Moderate to severe problems with body image are reported. Mr. Sample reports average levels of sexual concerns. Eating Disorder symptoms are not admitted to. He is excessively self critical to the point of creating self-fulfilling prophesies. Mr. Sample reports being extremely insecure about peer relations. Mr. Sample describes an average level of sensitivity to social cues. Mr. Sample admits to moderately delinquent tendencies. Multiple family problems are reported. Mr. Sample reports having unproductive school attitudes and behaviors. Mr. Sample has an average level of educational and life objectives.

DEPRESSION: In testing, Mr. Sample reports significant levels of depression. Many physical symptoms/signs of depression are endorsed.

ANXIETY: Moderate levels of anxiety are reported. Mr. Sample reports a strong subjective experience of anxiety.

PTSD/SEXUAL ANXIETY:

*An extreme level of overall current PTSD symptoms is reported. Mr. Sample described presently experiencing moderate dissociation. This dissociation strongly follows a classic pattern often found in PTSD. Mr. Sample also described a mild 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. A mild amount of distress with issues of sexuality was reported.

ANGER: Testing does not indicate undo amounts of Anger.

ANGER: At present Mr. Sample reports overall experiencing average amounts of anger. Average levels of current subjective angry feelings were admitted to. Mr. Sample now reports experiencing average pressures to be verbally aggressive and average current pressures to physically express angry feelings. Very high levels of Trait Anger are admitted to as Mr. Sample described himself as generally experiencing severe levels of anger. He is extremely quick tempered with anger often evoked with minimal provocation. Mr. Sample is overly sensitive to criticism and rejection and may perceive or exaggerate criticism and rejection where none actually exists. Mr. Sample displays severe tendencies to be authoritarian and often intimidates others with his anger. Once anger is consciously experienced, Mr. Sample makes very strong initial attempts to suppress his anger from awareness. However, his efforts to suppress anger are generally unsuccessful since Mr. Sample reports often experiencing heightened levels of anger. Well above average amounts of energy are then invested in reducing and controlling the remaining conscious anger. Despite significant efforts to control anger, Mr. Sample's present coping skills do not appear to be effective, as significant levels of anger are still experienced. Mr. Sample describes making mild efforts to control, rather than act out on, anger once consciously experienced. Severe overall tendencies to act out on anger are said to exist. Angry feelings are likely to be expressed either verbally and/or behaviorally. 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.

EMOTIONAL SENSITIVITY/IMPULSE CONTROL: 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. Impulse control is poor. Mr. Sample does not subjectively feel out of control of his impulses.

ENERGY LEVEL: Mr. Sample's reported energy level is mild to moderately raised. Moderate psychomotor hyperactivity is reported. Moderate psychomotor retardation is reported.

MMPI-A: The MMPI-A reveals significant addiction proneness and possible substance use. In this test, Mr. Sample does acknowledge having significant substance use-related symptoms and attitudes.

MACI: MACI results do not indicate substance abuse.

SASSI-A: Mr. Sample reports absolutely alcohol sobriety. Mr. Sample reports absolutely no drug use or use-related symptoms on face valid measures. Average levels of Obvious Attributes empirically found among chemically dependent individuals exist. Average levels of Subtle Attributes of chemically dependent individuals were found. Testing does not support a diagnosis of chemical dependency.

• CLINICAL INVESTIGATION OF POSSIBLE SUICIDAL IDEATION SHOULD OCCUR.
• IMMEDIATE INVESTIGATION OF POSSIBLE HOMICIDAL IDEATION SHOULD OCCUR.
• Mr. Sample NEEDS TO BE CHECKED MEDICALLY.
• PSYCHIATRIC REFERRAL FOR MEDICATIONS IS WARRANTED INCLUDING MEDICATION FOR: DEPRESSION, ANGER
• Due to possible learning problems, use redundancy and multisensory input.
• Immediate interventions to alleviate emotional distress are suggested.
• Mr. Sample's excellent abstract reasoning ability should be an asset.
• Exploration of the causes of visual problems and presentation material verbally.
• Mr. Sample is most likely to respond to peer feedback.
• Due to interpersonal mistrust, therapists must slowly build rapport.
• Praise and positive reinforcement is particularly useful.
• A Cognitive Behavioral Criminal Thinking approach is primary.
• Value adjustment work using educational/Cognitive Behavioral approaches.
• Avoid Power struggles with consistent matter-of-fact consequences.
• Encourage him to be responsible and accountable for his actions.
• External structure and restraints and liaison are needed.
• Consistently use discrete target behaviors and immediate consequences.
• Teach better coping than through somatic problems.
• Do not let Mr. Sample's somatic concerns lead to avoidance.
• Significant Depression is reported requires treatment.
• Mr. Sample needs to learn anger control techniques.
• Help him identify anger provoking situations before autonomic reactions develop.
• Teach how to detach from and reframe anger once it is evoked.
• A stress inoculation approach coupled with self-esteem work may be helpful.
• Mr. Sample needs to put more effort into dealing with angry feelings.
• Teach mood regulation through Cognitive Behavioral therapy and medication.
• Give cognitive behavioral therapy for impulse control and problem solving.
• Teach to acknowledge and then detach from his feelings.
• Use Insight-oriented technique to resolve underlying emotional conflicts
• Self-defeating patterns evident in testing must be addressed.
• Family therapy may be indicated.
• A need for vocational preparation and guidance is seen.
• Social skills training is recommended.
• Help develop self-confidence and assertive skills.
• A Social Learning component is needed to teach prosocial skills.
• Help Mr. Sample develop a sense of identity and a stable value system.
• Encourage Self-esteem through the mastery and positive behavior.
• Intensive AODA treatment is required.
• Low levels of normal sexual drive need to be assessed and remediated.
• Mr. Sample's extremely limited range of sexual practices should be evaluated.
• Explore the impact of his conservative, traditional sexual values.
• The clinical effects cross sex traits should be explored.
• Due to dissatisfaction with his sex life, treatment is indicated.
• Sex education is essential.
• Hold him behaviorally accountable for his sexual behavior.
• Much Step 1 work and carefrontation is needed to develop motivation.
• Specialized treatment for pedophilia is warranted.
• Mr. Sample must replace sexual fantasies of youth.
• Mr. Sample must not be allowed to be in places where potential victims are.
• Treatment on victim empathy and Covert Sensitization are indicated.
• Mr. Sample admits to significant paraphilias that may require specialized treatment: FETISH, OBSCENE CALLS,
• Mr. Sample reports signs of sexual dysfunction/disability that may require further medical and/or psychological treatment and that could be a factor in sexual acting out.
• 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.