Psychological analysis

Jonathan Rich, Ph.D.

Psychologist PSY 10259

7545 Irvine Center Drive, Suite 200         (949) 623-9824

Irvine, CA 92618                                 jrich@PsychologicalTesting.com

PSYCHOLOGICAL EVALUATION

Client’s Name: Frank

Date of Birth: 1978

Date of Assessment: 6/30/2012

Home Street Address: Carson, South California 

Telephone #: —

Service Coordinator: J Rich 

Referred By: —-

IDENTIFICATION AND REFERRAL:

Frank is a 34-year-old man. He was driven to the examiner’s office by his fiancée the mother to his son. He admitted that he is going through a divorce yet to be finalized within the month. He has had his license revoked for driving under the influence of drugs. He has also had alcohol related challenges from the ages of between 12 and 13. He has had several run-ins with the law and had a five year jail sentence served as well as the probability of having an active arrest warrant at the moment. He has also admitted to have a problem with use of drugs. He is being assessed to determine his current state of mind and willingness to seek help in dealing with the drug problem.

History

The history was provided by Frank.

Family History

Frank is going through a divorce process soon to be finalized. He is a father to two children one son aged 17 months and a daughter who died at an early age of 55 days old. He has admitted to have had issues with drug use and crime which is the likely cause of the divorce. 

Frank was raised by a single parent after his parents divorced when Frank was about 4-5 years of age. Frank was born in Carson City, and has always lived in South California.

Educational and Vocational History

Frank studied up to grade 10 and holds a General Education Development. He has worked in various vocational jobs learning through apprenticeship. The most recent job he had was an iron worker in the year 2007. Previously he worked in welding, security and hanging glass positions. The last job had to end after he got into a job related accident when he fell 30ft and injured his knee.

Medical and Mental Health History

Frank reported that he has a pinched nerve in the back as well as severe migraines. He is not on any medication at the moment. The only surgeries Frank has undergone are; one reconstructive surgery for his shoulder and reconstructive surgery for the knee injury he acquired while at work. 

With regards to mental health, Frank has not been placed in a psychiatric hospital in his life. He has however, engaged in several psychiatrist’s sessions the first instance being at the age of 23. He had a few sessions while incarcerated. He needed help in dealing with an urge to use drugs in order to get high. The psychiatrist prescribed Haldol, Mellaril and Sinequan after diagnosing an addition problem in Frank. Frank has never attempted suicide. 

Antisocial Behaviors/Substance Abuse

Frank has been arrested and charged with crimes over five times. Has been charged mostly on drug related incidences. At the age of 23 to 29, he was incarcerated for child endangerment which resulted in his young son’s death. Frank also admits that he may have an active arrest warrant out for him. He was once jailed for failure to completed drug counseling. He uses alcohol a few times in a week. His drinking problem manifested at an early age of 12, and has consequently been in trouble with the law for heavy drinking and he is currently divorcing due to his tumultuous lifestyle putting a strain on his family life. He has used illicit drugs like cocaine, PCP, heroin and barbiturates. He reported that his time to use a drug was at the age of 14 and the last time to use a drug was a month prior to the assessment visit.

Daily Functioning

Frank does not drive a car since his license was revoked a year ago for driving under influence. He is able to shower, bathe and dress independently as well as keep track of his bills and pay them without help from other people. In his typical day; Frank talks to his son’s mother on phone, build sales models and occasionally has phases when he screams and throws things.

MENTAL STATUS:

General Appearance

Frank’s grooming and hygiene were adequate, his gait was also proper. He appeared his stated age. He has heavily tattooed forearms, keeps his hair short and wears glasses.

Attitude and General Behavior

Frank was pleasant, cooperative, followed instructions and tried his hardest to accomplish the tasks he was charged with. Frank is also polite, he knew he would be late for the appointment and called in to say that he would be late prior to the appointment.

Mood and Affect

Frank had a broad sense of humor. He states that he has a little trouble sleeping but no problem with eating. When asked to describe his mood, he said that his mood fluctuates and lately has been going through periods of depression a few times in a month that last 4 to 5 days in a week. The first time he had that experience he was 15 years old. He maintains that he has not had any suicidal thought at any point in his life.

Stream of Mental Activity

Frank was coherent in his responses which remained relevant throughout the assessment. His rate of speech was normal and was 100% intelligible.

Sensorium and Orientation

Frank was alert and aware of his surroundings. He knew the correct current date, day of the week and his city of residence without a struggle.

Memory

Frank remembered his correct birth date and age, the name of the current and last presidents. He registered three objects after one trial and could recall all three after a five minute delay. He repeated eight digits forward and four digits in reverse. 

Fund of Information

Frank’s fund of information was above average. He was able to correctly state the boiling point temperature of water and state the direction of the sunrise.

Concentration and Attention

Frank demonstrated adequate ability to concentrate and follow instructions. He counted from 20 to 1 in eight seconds without making an error.

Perceptual Distortions

Frank was responding to internal stimuli of revenge which he mostly experiences in periods of deep depression usually about 2 to 3 times in a year.

Judgment/Insight

Frank’s judgment was good. His response to a case where a neighbor’s house is on fire, he would grab a hose pipe and call 911. His insight, however, is poor. He admits that he has depression but denies the fact that he needs treatment and is not committed to stopping substance abuse.

TESTS ADMINISTERED:

Wechsler Adult Intelligence Scale, 4^rd Edition (WAIS-IV)

Wide Range Achievement Test, Revision 4 (WRAT-4)

Minnesota Multiphasic Personality Inventory, II (MMPI-II)

TEST RESULTS:

WAIS-IV

Index Scores

Verbal Comprehension 93

Perceptual Organization 109

Working Memory 115

Processing Speed 99

Full Scale 103

Verbal Subtest Scaled Score Performance Subtest Scaled Score

Vocabulary 9 Block Design 12

Similarities 7 Matrix Reasoning 11

Information 10 Visual Puzzles 8

(Comprehension) 12 (Figure Weights) 12

Arithmetic 11 (Picture Completion) 8

Digit Span 16 Coding (Digit Symbol) 8

(Letter-Number Sequencing) 11 Symbol Search 12

On the WAIS-IV, Frank was able to score a Full Scale IQ of 103. This score is near the high end of the Average Range of Intelligence and exceeds 70 out of 100 persons his age. His Perceptual Reasoning Index was significantly lower than his Verbal Comprehension Index, a reflection that he is better with tasks that require less nonverbal reasoning than those which do not. 

Frank’s Verbal Comprehension Index of 93 exceeds 55 out of 100 persons his age and is in the Average range.  This reflects an above average fund of general information, knowledge of words and understanding of social conventions, and abstract verbal reasoning that is above average range.  

Franks’s Perceptual Reasoning Index of 114 exceeds 82 out of 100 persons his age and is in the High Average range.  This reflects relatively strong nonverbal reasoning.

Frank’s Working Memory Index is in the High Average range and is a relative strength.  This reflects strong auditory attention and concentration.  Frank’s processing speed is consistent with his generally average level of functioning.

WRAT-4

WRAT-IV

Subtest Standard Score

Word Reading 93

Sentence Completion 98

Spelling 89

Math Computation 95

Reading Composite 96

On the WRAT-4, Frank demonstrated sight-reading and spelling abilities that were average and consistent with what would be expected given him general level of intelligence. His reading comprehension abilities were a bit weak. His reading comprehension is in an average range. While he is able to read orally at a 10^th grade level, him reading comprehension is in line with his 10^th grade level.

The discrepancy between his general level of intelligence and his reading comprehension is sufficient to be considered a reading challenge.  His Math Computation skills were in a superior range and above a high school level. Frank was able to add, subtract, multiply and divide whole numbers, decimals, and fractions. He was able to work with percentages. (Rich, 2011)

MMPI-2

Scale	T-Score
L(Lie)-Scale	68
F(Infrequency)-Scale	45
K(Correction)-Scale	56
1-Hs	70
2-D	55
3-Hy	65
4-Pd	40
5-Mf	53
6-Pa	48
7-Pt	59
8-Sc	54
9-Ma	48
0-Si	50

On the MMPI-2, Frank’s responses to the items indicated that, on this test administration, he might have felt the need to present as having strong moral character or to deny having any weaknesses. Despite this tendency to present himself in a positive light, his responses can be considered a good reflection of his current state and the current protocol can be considered valid.

Significant elevations were seen on MMPI-II scale 1 and 3.  Scale 1 reflects concern about bodily function.  Individuals with elevations on this scale tend to have multiple vague physical complaints and tend to convert emotional distress into physical symptoms.  Elevations on scale 3 are seen in individuals who are interpersonally demanding and tend to maintain shallow relationships.

The combined elevation on scale 1 and 3 generally reflects an individual who is conforming and conventional.  Such individuals value being seen positively by others.  Frank may be emotionally under controlled and express anger and other negative feelings in direct ways.

Scale 2 measures depression.  This scale was within the normal range, suggesting that Frank’s depressive symptoms are currently not well controlled.

DIAGNOSTIC IMPRESSIONS:

296.35 (F33.41) Major Depression, recurrent, in partial remission due to medication

315.00 (F81.0) Specific Learning Disorder, with impairment in reading: Reading comprehension

SUMFRANK AND RECOMMENDATIONS:

Frank is a 34-year-old man. He has a history of major depression, and a long history of drug use and crime. At present, his depression appears to be poorly controlled by lack of therapy and medication. He reports functioning poorly at his job and changing jobs quite frequently. He currently appears to maintain poor emotional stability. This testing reflected intelligence near the high end of the average range and strong math skills, but low average reading comprehension.  Considering that he only managed to get to grade ten and is currently emotionally unstable, it is likely that he could take longer to seek professional help. However, the present testing suggested that he struggles with reading comprehension, and may need accommodations to compensate for a reading disorder. (Eabon & Abrahamson, 2017)

Thank you for referring this pleasant man for assessment.

________________

Jonathan Rich, Ph.D.

References

Eabon, M. F., & Abrahamson, D. (2017). Understanding Psychological testing and assessment. Retrieved from American Psychology Association: https://www.apa.org/helpcenter/assesement.aspx&grquid=CL_h1V3z&hl=en=KE

Rich, J. (2011). Administration and Interpretation. Wechsler Adul Intelligence Scale.