Monday, May 12, 2008

My Psych Evaluation

In keeping with my diagnosis of Narcissistic personality disorder, I've decided that my psychological profile is so awesome and important that everyone in the world must see it lol.

Here it is people, my psych evaluation.

I am not impressed. For one I am misquoted several times and we're not talking about tiny errors, we're talking about total sentence confusion and complete misunderstanding.

I'll be adding correction in double parins, the rest is maintained verbatim as far as I know, if you find errors let me know.

Scans of the original document will be linked.

PSYCHOLOGICAL EVALUATION •

All information and the results herein are based upon information gathered from the claimant and the evaluation process and have not been independently validated. The nature and purpose of the examination were discussed and he agreed to proceed.

CHIEF COMPLAINT:
Brandon Sergent presented as a twenty-eight-year-old, single, Caucasian male who was referred for a Psychological Evaluation by the Department for Disability Determination Services. Per the referral form, he complains of difficulties with "cerebral palsy, deformities of the right band and foot, social anxiety, dyslexia and other phobias." ((This is not at all how I put it, but it is generally accurate)) When asked what was keeping him from maintaining employment, Mr. Sergent stated, "For one, every time. I apply for a job, they look at the handwriting and say, 'Seven year old.' Then they say, 'Next.' I can't drive. Cars freak me out. I don't talk to people. I have pretty significant philosophical differences from most people. The things I like thinking about are large-scale stuff ((This term I used was “macroscopic systems”))...I'm not really interested in small-scale stuff. " Mr. Sergent did not indicate when he first noticed affective difficulties other than "when I . was a toddler." ((She asked me when my problems began directly after a physical series of questions, I assumed she was asking about my CP)) The claimant had been working as a janitor ((maintenance, please.)) in a nursing home. He last worked January, 18, 2008 and quit working because he "was too tall for the floor buffer." ((Yea, there was a lot more too it than that. See my post on the subject. )) He stated his employer then moved him to "mopping. ((I was never moved and I never said I was moved, I was a mop guy from the outset.)) That entailed. walking ten miles a day. I could do that if I had a day to rest in between but I had to do that every day." He stated additionally "I tried to help the residents because they asked me to and it wasn't my job, I think they deserve to sleep through the day if they want to." ((This sentence is a bizarre composite, again see my post)) There have not been further attempts to return to work. ((I've actually applied to several places since then, I can only speculate why I haven't gotten interviews.))

Psychological Evaluation
page 2 of 7
He denies ever receiving disability benefits. He believes that both physiological and psychological difficulties are impairing his ability to sustain employment. ((Put more correctly I believe a combination of them are to blame. No single problem stops me.))

BEHAVIORAL OBSERVATION:
Brandon Sergent presented as a twenty-eight-year-old, single Caucasian male. He is reportedly 6' 4" and weighs 225 pounds. ((I was off by 8 pounds)) He has brown hair and blue eyes. His father drove him to the appointment. He completed the questionnaire and interview alone. He was clean, neat, and appropriately dressed. ((Awww, why thank you)) He was alert and oriented in all spheres. ((Actually the whole thing took places in a series of cubes with doors but whatever.)) No particular difficulties with hearing were noted. ((on the part of the subject anyway, apparently the woman testing me can't hear too well)) He does wear glasses and did so during this evaluation. Eye contact was appropriate. No difficulties were noted with fine- or gross-motor coordination. Mr. Sergent stated ((And showed her, I wear step ins.))he wears a size 12 shoe on his left foot and a size 8.5 shoe on his right foot. However, he was not noted to have difficulty navigating the office and sat and arose with no apparent difficulty. He was noted to be right-hand dominant. His general activity level was age and task appropriate. Suicidal ideation, homicidal ideation, substance abuse, hallucinations, and delusions were all denied. He stated he has had suicidal thoughts in the past, "but never, seriously." Rapport was adequately established for the purpose of this evaluation. ((The woman was a robot.)) Speech was generally relevant and coherent. His affect was appropriate, within appropriate limits and mood-congruent. There were no indications of psychotic process and thought process was unremarkable. Insight and judgment appear good. His overall attitude with the assessment situation was appropriate and he maintained a presentation of good effort and interest. It is believed that Mr. Sergent presented in a manner consistent with his abilities; therefore, the following results are believed to be an accurate estimate of his current level of functioning. ((So I'm not a liar, awesome.))

HISTORY
Brandon Sergent is an only child and was raised in the Ashland, Kentucky area by his biological parents. History is negative for abuse and neglect. He currently resides in the Ashland, Kentucky area with a male roommate. He has never married and has no children. ((Bet they think I'm gay, everyone else my age in this town is married or paying child support.))

He completed high school and reports he received special education classes. ((Only in middle school)) He stated he was in LD classes and AP classes. He attended some college ((56 credit hours and 3 years, she makes it sound like I went there one summer)) and stated he quit because he disagreed with the board. ((Wow, there is SO much more to that, and I explained it in detail.))He reported he was president of the Student Government Association while attending Ashland Community and Technical College. "Anytime I wanted to speak to the students, I had to clear it with the board. ((This is a literal truth, mass emailing was strictly controlled and there was no school paper, and public presentations had to be cleared.)) The comparative religion class put up a Buddhist Shrine and took it down because he (the college president) said it was religious. ((I refer to him as Adkins, because that's his name.)) They also deleted my major twice. I didn't go back. I would love to finish my degree but I will have to do it somewhere else." ((tuition has gone up every single year, and I've exhausted my work study funds and the secondary grant you get for having a high GPA, there aren't scholarships for atheist white single men who are not soldiers, felons, or aspiring CEOs)) He repeated the first grade. ((For “Social reasons”. )) Difficulties with sustaining attention- and behavioral disturbance during his schooling were endorsed. ((ADHD, Ritalin)) He stated be quit school because he "got tired of being beaten up. ((Three broken bones in 1.1 years, all at school. Rednecks HATE being made to look like idiots. Why think when you can hit. )) I got my GED a year before my graduating class graduated.” ((They forced me to wait)) Per his report, he has no difficulty conducting basic financial management necessary to purchase groceries, household goods, and pay bills. ((My credit score is like 618, pretty good for someone with almost no income.)) The claimant had been working as a janitor in a nursing home. He last worked January 18, 2008 and quit working because he "was too tall for the floor buffer." ((Didn't we cover this?)) He stated his employer then moved him to "mopping. That entailed walking ten miles a day, I could do that if I had a day to rest in between but I had to do that every day." He stated additionally "I tried to help the residents because they asked me to and it wasn't my job. I
think they deserve to sleep through the day if they want to."

Brandon Sergent
Psychological Evaluation
Page 3 of 7

There have not been further attempts to return to work. ((Again, no one will interview me.)) He denies ever receiving disability benefits. He believes that both physiological and psychological difficulties are impairing his ability to sustain employment. ((combination))

History is reportedly positive for legal difficulties in that Mr. Sergent stated, "A long time ago...my friend stole some Nintendo 64 controllers and brought them to my house. He got in trouble and I got receiving stolen property. I had to write a letter of apology. Also when I was trying to force myself to learn to drive, I got pulled over. It was totally unrelated to anything I did.. It was the car."

Per the referral, form, he complains of difficulties with "cerebral palsy, deformities of the right hand and foot, social anxiety, dyslexia and other phobias." When asked what was keeping him from maintaining employment, Mr. Sergent stated, "For one, every time I apply for a job, they look at the handwriting and say, 'Seven year old.' Then they say, 'Next.' I can't drive. Cars freak me out. I was in a car wreck as a toddler and everybody else got broken bones, I didn't get any thing but it freaked me out. I don't talk to people. I know it's irrational but I feel like I'm constantly being judged, constantly bothering them. That makes it hard to be proactive and go do anything. I worked three years in a lab and that was heaven. ((Work study))P eople had 'to come to me so I didn't have to worry about bothering them. Every other job...feel like I have to sell them stuff...My last ((actually it was my first)) job... got fired because I wouldn't `up-sell.' I have pretty significant philosophical differences from most people. ((Well, I do.))They'll talk about NASCAR or church and I'm just not interested and I feel like they feel like I'm nervous. I have a book...self-published...I have a blog. The things I like thinking about are large-scale stuff...I'm not really interested in small-scale stuff." ((See above)) Mr. Sergent did not indicate when he first noticed affective difficulties other than "when I was -a toddler:" He stated he has no problem riding in vehicles with others at this time. “I don't want. to be responsible for crushing someone. I don't want to be mangled. I was hoping someone . would try to help me find a job.. I'm a certified locksmith. I put that on my resume and mom said, `well they probably don't trust you because locks won't keep you out.' I get so mad with people. They upset me so much that it messes with my digestive system." ((True)) Mr. Sergent stated he also has Borderline Personality Disorder: When asked how he knew this and if he had been diagnosed . with this disorder, he stated he has never been diagnosed with Borderline Personality Disorder but has taken "all those cute tests online." He then continued, "I'm aware that others may see me as that. I have the extremism, black and white perception. I do that, it either is or not. Gray areas are just a way of saying indecision."

History is negative for psychiatric hospitalization and psychotherapy. He is not currently in treatment Mr. Sergent stated at first that he did not think he would benefit from treatment. "I'm too opinionated." He then stated, "I don't know, maybe." He is not prescribed any psychotropic medications. He reportedly was prescribed Ritalin "for a long time" as a child, There is no evidence of self-injurious or suicidal behaviors by the claimant at this time.

Prenatal and developmental histories are remarkable in that he reported he was born "at least" one month early. He stated he was in an incubator for an unknown period of time and that his mother "blames the doctor for my having CP." ((Really, she just mixed and matched a bunch of things I said.)) He stated he was delayed in walking due to "CP on my right side." Additionally, he stated he had several broken bones as a child. (( Three were in high school. )) "Four major broken bones and some toes and ribs. I broke my left wrist two times, my right wrist one time ((Form being pushed.)) and my left arm one time." His report of the behaviors that led to the injuries is striking for someone who was reportedly traumatized as a toddler and is afraid of most things. ((I never said anything even approaching that, I just said I don't like cars and cold calling.))

History is negative for head injury and seizures. There are no known drug allergies. He has had a toenail surgically removed. Other medical conditions reportedly include cerebral palsy. There are no other medications prescribed. He stated he takes Advil for pain, illicit and/or N drug use, past or present, was denied. He consumes approximately one caffeinated beverage daily. He denies the use of tobacco products. He reported alcohol use as "a couple of shots of bourbon when I'm playing cards with friends." He gets exercise by bike riding. "I ride my bike everywhere." Sleep is reportedly ten hours per night. ((Sometimes, sometimes 3-5, honestly, this chick is starting to upset me.))

Appetite appears adequate. ((I have no idea how she would note this expect that maybe I look fat? lol))

Currently, a typical day includes "general maintenance and computer." He does not have any regular, structured activities. Social interactions, per his report, are limited in that "people scare and disgust me. I avoid them. ((I have enough friends and they tend to betray the shit out of you so I'm letting them drop away one at a time until I only ave REAL friends left))" However, he stated he plays cards with friends frequently ((Two friends, and I recently stopped going over there.)). He is psychologically able to conduct daily housecleaning, personal hygiene, and can go to the grocery store independently as needed. Mr. Sergent reports good interpersonal relationships with family members ((The two I see regularly anyway.)) and some prior supervisors and coworkers. He demonstrates the ability to sustain attention to tasks and to complete tasks in a timely fashion. ((Tasks like assembling blocks and and doing simple math.))

TEST RESULTS:
Sergent was administered 11 subtexts of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) from which his IQ and Index scores were derived. Mr. Sergent's general cognitive ability is in the High Average range of intellectual functioning, as measured by the Wechsler Adult Intelligence Scale -Third Edition (WAIS-III). His overall thinking and reasoning abilities exceed those of approximately 87% of adults his age (FSIQ 117; 95% Confidence Interval,113-121). The following are his obtained scores: ((Removed due to OCR errors, see original scans))

His verbal reasoning abilities, as measured by the Verbal IQ, are in the High Average range and above those of approximately 86.0% of his peers (VIQ –116, 95% Confidence Interval I1.1 - 120). On the verbal reasoning subtests, Mr. Sergent obtained his highest score on the Vocabulary subtest. His performance on this subtest differs significantly from his Verbal subtest mean score and suggests that this is the area of most pronounced strength in Mr. Sergent's profile of verbal reasoning abilities. His strong performance on the Vocabulary subtest is much better than that of most adults his age. Mr. Sergent's Verbal Comprehension Index score is generally comparable to his Verbal IQ score. On the Verbal Comprehension. Index, Mr. Sergent's performance is much better than that of his peers. His ability to understand and respond to verbally presented material is equal to or exceeds that of 96.0% of others his age (VCI = 126, 95% Confidence Interval 119-131).

His nonverbal reasoning abilities, as measured by the Performance IQ, are in the High Average range and better than those of approximately 86.0% of his peers (PIQ 116, 95% Confidence Interval 108-122). On the nonverbal reasoning subtests, Mr. Sergent obtained his highest score on the Block Design subtest. His performance differs significantly from his Nonverbal subtest mean score and suggests that this is the area of most pronounced strength in Mr. Sergent's profile of nonverbal reasoning abilities. Much better than that of most of his peers, Mi. Sergent's performance demonstrates very strong abilities on the Block Design subtest; On the Perceptual Organization Index, Mr. Sergent performed better than 92.0% of his peers (POT = 121, 95% Confidence Interval $112-127). However, his abilities are variable, with his performance suggesting unevenly developed skills in this area.

His ability to think with words is comparable to his ability to reason without the use of words. Both Mr. Sergent's verbal reasoning and nonverbal reasoning abilities are in the High Average. range. On the basis of his WAIS-III performance, Mr. Sergent's verbal comprehension skills and
his nonverbal reasoning abilities are comparable. ((Remember this part, its funny later.)) Relative to his peers, Mr. Sargent exhibits. strengths across all domains.

On the WRAT-4, Mr. Sergent obtained a standard score of 110 on Word Reading, which is within the 75th percentile and equivalent to a grade =we of >12.9. On Spelling he obtained a 98
standard score, which is in the 45th percentile and equivalent to grads score of 12.7. The standard score of 93 on Math Computation is equivalent to the 32nd percentile and a grade score of 8.8. With the exception of his score on Math Computation, these scores are concomitant with his obtained WAIS-III scores.

The figures produced for the House-Tree-Person suggest withdrawal tendencies, inadequacy feelings and rejection of the home and home life. ((I suppose thats fair.)) There are also indications of regression and infantile aggressive, assaultive tendencies. ((And yet I haven't been in a fight since middle school.))

The REY 15-Item "Memory" Test is a nonverbal memory task, which is designed to determine the validity of complaints of memory impairment. The task consists of a 10 second exposure to five rows of three characters, and the subject is instructed to recall all of the 15 items in order to provide the impression that the task is difficult Results of research on this task have indicated that with, the exception of those with severe brain injury or mental retardation, individuals recall a minimum three of five sets of characters, If a subject recalls fewer than three sets, it can be deduced that the person has exerted inadequate effort and motivation. Mr. Sergent recalled five of the five sets, which indicates that there was not an attempt to exaggerate his symptoms on this instrument.

Mr. Sergent reports symptoms indicative of Narcissistic Personality Disorder. ((But I thought I was superior across all domains, so whats pathological about knowing I'm superior?)) These symptoms include a grandiose sense of self-importance((Can you prove I'm not enlightened? It seems you would have to to justify this positive claim of NPD)), a belief he can only be understood by, or associate with, other special or high-status people((Is that believe not justified by the whole psychiatric community? Do they not sell us the idea that only they have the REAL answers?)), a lack of empathy((Bullshit, my whole driving goal is the elimination of pain for my entire species,)), and a history of interpersonal difficulties. It is the opinion of this clinician that Mr. Sergent's perception of fearing and not liking people is more related to his personality dysfunction than an affective disturbance, but he is interpreting it as affective disturbance. ((To my understanding as a result of looking it up, Affective disturbance (AD) refers to feelings of anxiety or sadness, or both. Do you see the logic trap there? ))

While the WRAT-4 is a screening instrument and is not suitable for diagnosing learning disabilities, his obtained scores on the arithmetic portion of this instrument suggest that possibility and that further testing may reveal he has a mathematics disorder. Therefore a rule-out for Mathematics Disorder is also offered.
DIAL TIC S ON:
Axis I: V71.09 No diagnosis
R/O Mathematics Disorder

Axis 301.81 Narcissistic Personality Disorder
Axis IH: Per claimant report: Cerebral Palsy
Axis IV: Occupational
Axis V: • GAF: 74
P,ROGNM:

History is negative for psychiatric hospitalization and psychotherapy. He is not currently in treatment. Mr. Sergent stated at first that he did not think he would benefit from treatment "I'm too opinionated." He then stated, "I don't know, maybe." ((Definitely not now since apparently they'd try to “cure” what little self esteem I have left)) He is not prescribed any psychotropic mediation, He reportedly was prescribed Ritalin "for a lone time" as a child. There is no evidence of self-injurious or suicidal behaviors by the claimant at this time. ((Actually I was a cutter and have scars all up my left forearm, eheheh, a relic of my Goth/Emo roots))

Based upon clinical findings, while it is believed his symptoms are primly characterological in nature and will resist change, they are not severe enough to preclude his obtaining and maintaining some form of gainful employment. Prognosis is good.

Based solely upon objective findings and the results of this evaluation, it is the clinical opinion of this examiner that Mr. Sergent is not psychologically limited in his ability to function in an occupational capacity. ((Sweet, wonder if they'd hire me.)) He demonstrates the ability to understand and remember simple instructions, There is no evidence of a disturbance in sustained concentration and/or persistence.

Although Mr. Sergent stated he has a "fear" of people and does not socialize, he had no difficulty conversing with. the clinician and stated he plays cards with friends frequently. ((Two friends whom I've known for 10 years or more)) It is believed that Mr. Sergent has the resources available to adapt and respond appropriately to pressures normally found in the day-to-day work setting.

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1 comment:

None of my business really said...

The woman who made that Dx used instruments to make a diagnosis in a vacuum. That's bad clinical (I am 15 units short of a Masters in Clinical Psych, which I intend to never finish). Look up "Fundamental Attribution Error" (and also "Ultimate Attribution Error"). The Fundamental Attribution Errror goes something like this: If I behave a certain way [ that is outside of normal limits or what social norms dictate ], my tendency is to see it as being born out of my current context. But if another does the same thing, my tendency is to see it as a train of character or personality.

You have not been employed for months and you were under-employed before that. Your self-esteem is probably in the pits, at least at times. Add that to your were naive enough to communicate like a real person to someone who does not want real communication, and you were punished for it.

I do not know you well enough to say that you do not have a personality disorder. I can say that you have not demonstrated anything beyond the norms of "arrogant young man" which fits with your age and testosterone levels.

About

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I'm a politically and culturally subversive author with obsessive tendencies and a lot of free time. I feel a sense of personal responsibility for the fate of my species. My writing is the result.

My primary blog is at http://underlore.com but this G+ profile is a far more active representation of my viewpoint.

Generally I feel the answer to society's ills are technological in nature not political or cultural.

Having said that, I do have political positions of course and I strongly feel that we need to embrace nuclear power and deploy a universal basic income.