COUN 521 CEFS 521 Benchmark: Psychological Report Assignment Instructions Overview You will write a Psychological Report Assignment based upon four (4) psychological evaluations and information reported in the Initial Interview Assignment and Mental Status Examination (MSE) Assignment. Counselors are commonly required to write a psychological report that presents assessed and observation information about a client. This Psychological Report Assignment will require students to synthesize and report information about the character depicted in the Initial Interview Assignment and Mental Status Examination (MSE) Assignment. Instructions · Length of Psychological Report Assignment: 2100-2400 words (not including the title page) · Format of Psychological Report Assignment: APA for font (Times New Roman, 12 pt.), title page, margins, and section headings · Number of citations: none · Acceptable sources: none Using your character from the Initial Interview Assignment and Mental Status Examination (MSE) Assignment, you will take the assessments with the goal of answering one (1) of the referral questions posted below: 1. Would this examinee be a good candidate for participation in a summer missions trip in a very challenging environment? 2. Would this examinee be a good candidate for Senior Pastor at a large urban church? 3. Would the examinee make a good Resident Assistant (RA) at Liberty University? Assessment Selection You will report on four (4) assessments. For one of your assessments, you must use the IPIP-NEO assessment (see Psychological Report Resources for the link). There are two versions (short/long) of the IPIP-NEO assessment. Please use the longer version. Copy and paste the NEO description and chart into the report. This will give you a nice template for writing an assessment description. Once you have the results of the IPIP-NEO, you will plug in your own numbers into the chart. The three (3) additional tests may come from the assessment listed on Blackboard: Jung Personality Test, Beck Depression Inventory, and the Beck Anxiety Inventory. However, you may select other assessments to replace these assessment. Please make sure that any assessments that you select are designed to provide some of the information needed to answer the referral question. For example, if going on a mission trip is stressful, then you will want to pick an assessment that measures stress; you would not pick one that can be used to diagnose schizophrenia. When you have completed scoring the assessments, begin writing the psychological report. You may not use the Symptom Questionnaire (SQ); Depression, Anxiety, Stress Scales (DASS) or the Clinical Anxiety Scale (CAS). These assessments are used in the sample paper, so you may not use them in your report. This would be plagiarism. Please refer to the Psychological Report –Diagnostic Report Sample to ensure that you correctly format your Psychological Report Assignment paper. For this, you will not use A ...

1. COUN 521
CEFS 521
Benchmark: Psychological Report Assignment Instructions
Overview
You will write a Psychological Report Assignment based upon
four (4) psychological evaluations and information reported in
the Initial Interview Assignment and Mental Status Examination
(MSE) Assignment. Counselors are commonly required to write
a psychological report that presents assessed and observation
information about a client. This Psychological Report
Assignment will require students to synthesize and report
information about the character depicted in the Initial Interview
Assignment and Mental Status Examination (MSE) Assignment.
Instructions
· Length of Psychological Report Assignment: 2100-2400 words
(not including the title page)
· Format of Psychological Report Assignment: APA for font
(Times New Roman, 12 pt.), title page, margins, and section
headings
· Number of citations: none
· Acceptable sources: none
Using your character from the Initial Interview Assignment and
Mental Status Examination (MSE) Assignment, you will take
the assessments with the goal of answering one (1) of the
referral questions posted below:
1. Would this examinee be a good candidate for participation in
a summer missions trip in a very challenging environment?
2. Would this examinee be a good candidate for Senior Pastor at
a large urban church?
3. Would the examinee make a good Resident Assistant (RA) at

2. Liberty University?
Assessment Selection
You will report on four (4) assessments. For one of your
assessments, you must use the IPIP-NEO assessment (see
Psychological Report Resources for the link). There are two
versions (short/long) of the IPIP-NEO assessment. Please use
the longer version. Copy and paste the NEO description and
chart into the report. This will give you a nice template for
writing an assessment description. Once you have the results of
the IPIP-NEO, you will plug in your own numbers into the
chart.
The three (3) additional tests may come from the assessment
listed on Blackboard: Jung Personality Test, Beck Depression
Inventory, and the Beck Anxiety Inventory. However, you may
select other assessments to replace these assessment. Please
make sure that any assessments that you select are designed to
provide some of the information needed to answer the referral
question. For example, if going on a mission trip is stressful,
then you will want to pick an assessment that measures stress;
you would not pick one that can be used to diagnose
schizophrenia. When you have completed scoring the
assessments, begin writing the psychological report.
You may not use the Symptom Questionnaire (SQ); Depression,
Anxiety, Stress Scales (DASS) or the Clinical Anxiety Scale
(CAS). These assessments are used in the sample paper, so you
may not use them in your report. This would be plagiarism.
Please refer to the Psychological Report –Diagnostic Report
Sample to ensure that you correctly format your Psychological
Report Assignment paper. For this, you will not use APA
formatting for the headers and page numbers. You will write it
in a format consistent with a psychological report which you

3. can use for future reference. Be sure to head your Psychological
Report Assignment paper “Psychological Report.” Underneath
this heading, fill in the following information (include the
labels given):
Note: Your assignment will be checked for originality via the
Turnitin plagiarism tool.
Be sure to review the criteria on the Psychological Report
Grading Rubric before beginning this Psychological Report
Assignment.
See Psychological Report Resources under the Psychological
Report Assignment page.
Sections of the Psychological Evaluation Report
I. IDENTIFICATION:
Student ID#
Client’s Name: (you can use a fictitious name)
Date of Report:

4. II. REFERRAL QUESTION/REASON FOR TESTING: In this
section, you will write a brief description (3-4 sentences) of
why your subject is being tested.
III. ASSESSMENT METHODS: List the full names of all the
tests administered. The Examinee Biography should be the first
measure on your list.
IV. EXAMINEE BACKGROUND: In no more than 2-3
paragraphs, use information from the Initial Interview (or
Mental Status Exam) and write a well-organized succinct
summary of the examinee’s background based on the
information in the initial interview. Note that you will not
include everything from the initial interview in this section. For
example, you might decide certain pieces of information (e.g.,
perceived strengths and weaknesses, goals and aspiration, etc.)
fit better in the Psychological Impressions section because they
support or illustrate your interpretations of test results. See the
Diagnostic Report Sample’s Psychological Impression section
for more information.
V. SUMMARY OF TEST RESULTS: The name of each test
should be underlined and serve as subheadings in this section.
The following information should be reported for EACH test:
A. A brief description (4-5 sentences) of the test. The
information you report on each test will vary considerably, but
must include the purpose of the test, a general description of
any subscales, and a statement relating to scores and norms
(e.g., T-scores with a mean of 50 and a standard deviation of
10, specific raw score means, and standard deviations, etc.).
B. Delineation of your subject’s scores: both raw scores and
standard scores or percentiles (if applicable) should be reported.

5. C. Additional Notes
i. In this section, do NOT make any interpretive statements. Just
report the scores.
ii. In “real-world” settings, most likely you would NOT include
clients’ actual scores in the written report. Whether actual
scores are reported depends in large part on the intended
audience (e.g., other psychologists, attorneys or judges, parents,
etc.).
D. Example of a Test Summary:
Minnesota Multiphasic Personality Inventory (MMPI-2): The
MMPI-2 is a structured, self-report personality test that was
designed to assist in the assessment of personality and the
diagnosis of major psychiatric disorders. The MMPI-2 consists
of 10 clinical subscales measuring different domains of
psychological functioning or symptomology, several validity
scales assessing subjects' approaches to taking the test (e.g.,
defensiveness, acquiescence), and content scales relating to a
specific content areas (e.g., anger). Distinct norm are provided
for male and female examinees. MMPI-2 scores are reported in
standard T-scores (mean=50, SD=10), with scores above 65
falling in the clinical range.
John's scores on the MMPI-2 are presented below; standard
scores are given in boldface type followed by raw scores in
parentheses:
Scale 1, Hypochondriasis: 45 (11).
Scale 7, Psychasthenia: 72 (39).
VI. PSYCHOLOGICAL IMPRESSIONS: This section is the
most important (approximately 600-900 words). Your goal in
this section is to integrate test results into a cohesive summary.
In other words, rather than simply reporting each interpretation
on a test-by-test basis, you will integrate your interpretations.
For example, you should address how the examinee is likely to
interact with others. Findings from most of the tests will be

6. relevant to this question. While you will specify your sources of
information following each interpretive statement (e.g.,
Examinee Biography, specific subscales of a named test, etc.),
you must also make interpretations based on an integration of
findings from multiple sources.
A. Additional Notes
i. You are NOT expected to interpret every single result of each
test! After examining test results, try to identify consistent
patterns or characteristic styles that emerge on several
measures. Address findings that seem most relevant, important,
or interesting in the context of the referral question.
ii. In this section, youare stating hypotheses about the
examinee’s functioning. You can express the probabilistic
nature of your interpretations as follows:
a) “Test results indicate (or suggest) that...” (instead of “Test
results show that...”)
b) “John seems (or appears) to be...” (rather than “John is...”)
c) “It is possible that John could...” or “John is likely to...” (not
“John will...”)
B. Example (this represents only a portion of this section, not
the entire section):
In regard to interpersonal functioning, results of Test X (list
relevant scales here), Test Y (list relevant scales here), and Test
Z (list relevant scales here) suggest that John generally interacts
well with others. Specifically, he seems to be aware of the
needs of others and is likely to respond in a positive manner if
asked to help others. John’s family likely fostered his sense of
interpersonal responsibility; in his biography, John reported that
a primary influence in his life was his father, to whom John
credits his “unfailing loyalty to the people in my life.” In
addition, Test X (list relevant scales) and Test Z (list relevant
scales) indicate that John is rather extraverted. He likely will
enjoy having a lot of contact with people. He seems motivated
to seek out situations that will allow him to help others solve

7. problems and to feel good about themselves.
On the other hand, John may experience difficulties in certain
kinds of interpersonal situations. Results of Test Q (list relevant
scales here) and Test Y (list relevant scales here) indicate that
he tends to be somewhat anxious and unsure of himself.
Coupled with his strong need for affiliation (i.e., for others to
like and accept him) suggested in Test Z (list relevant scales
here) and supported by Projective Test A, John’s anxiety is
likely to surface in situations requiring assertive interpersonal
responses. For example, it is possible John feels somewhat
intimidated when challenged by others, and might acquiesce to
the wishes of others rather than assert his own opinions or
needs. In support of this hypothesis, John stated that one of his
perceived weaknesses was “speaking up for myself.” It appears
John would make a good team player because he is interested in
considering others' views, but could be challenged in leadership
roles requiring him to direct others or to make independent
decisions that might not be popular with peers, colleagues, or
subordinates.
C. Questions you might address in this section include (but are
not limited to):
i. Intrapersonal functioning: How does this person view
himself/herself? What are this person's intrapersonal resources
or strengths? What kinds of situations might pose challenges to
this person? Is this person motivated more by internal or
external influences/factors? How is this person likely to deal
with stressful situations of a personal nature?
ii. Interpersonal functioning: Is this person a “loner” or a
“people-person?” What are this person’s needs for interpersonal
contact? How does this person interact with others? How would
you describe this person's interpersonal style? How might this
person respond to interpersonal stressors or conflicts? Does this
person seem responsible and able to follow through on
commitments?

8. VII. CONCLUSIONS AND RECOMMENDATIONS: Begin this
section by writing 3-4 sentences summarizing the examinee’s
background and the referral question. Next, you will address the
referral questions by:
A. Stating an opinion or recommenda tion (e.g., acceptance or
rejection) relevant to the referral question.
B. Providing a set of statements that clearly and logically tie
your recommendation to integrated psychological impressions.
This section should highlight important findings that led you to
your conclusion.
Example:
John Doe is an unmarried 23-year-old Hispanic male who holds
a bachelor’s degree in Literature. Currently, John is employed
as an editorial assistant for a large publishing company. John
was referred for psychological testing as part of his application
to the Walden Three community. Based on findings from a
battery of psychological tests, it is the recommendation of this
examiner that John (should/should not) be accepted to the
Walden Three community for the following reasons…
Additional Notes
i. Regardless of your final opinion, decision, or
recommendation, you must adequately support it! All the
reasons you give should combine elements of your
psychological impressions with specific aspects of the referral
question. In other words, you should provide evidence
justifying your recommendation.
ii. The reasons you provide for your recommendation should
summarize material presented in the body of your Psychological
Report Assignment paper, and should NOT contain new
interpretations.

9. Refer to theAssessment Psychological Report: Diagnostic
Report Example document to see examples of how each section
must be completed and how the Psychological Report
Assignment must be formatted for final submission. Contact
your instructor if you have any questions.
Page 6 of 6
CEFS 521
Jung Typology Test (Based on MBTI®)
The Jung Typology Test is based on Jung’s and Briggs-Myer’s
Typology of Personality. It is NOT the Myers-Briggs Type
Indicator (MBTI). You can access the Jung Typology Test at the
website Human Metrics.com. When taking the assessment, do
not overthink the answers. Rather, go with your first hunch. For
some items, you will think of times when a preference is true
and times it is not. Go with the answer that describes your
preferences 51% of the time or greater.
Once you have finished, access the results (see below). You will
need all the information from this page. Then click on “Self-
Awareness and Personal Growth” and “Careers” links for
information specific to your preference type. Copy the
information into a Word document or print it off directly from
the site (http://typelogic.com/).
This is NOT an empirically validated assessment; DO NOT
administer to a client.

10. Ethical Feedback of MBTI® Results
1. Give results directly to the respondent as part of an active
discussion with a certified administrator. Never deliver results
in impersonal ways such as through e-mail or mail.
2. Present type results as a working hypothesis, a starting point
for further exploration.
3. Make it clear that the respondent is the expert; the only
person who can verify which type fits best.
4. Allow respondents to self-assess their preferences based on
the introduction to type, prior to giving results of the Indicator.
5. Do not become defensive if the respondent disagrees with the
report results. Help the respondent explore his or her hesitations
and identify a comfortable best-fit type.
6. Provide descriptions of all sixteen types to help determine
best-fit type. Recommend additional materials for further study.
7. Do not counsel a person toward or away from a particular
career, relationship, or activity based solely upon personality
type information; personality type does not explain everything.
8. Make it clear that the preference clarity indexes in the results
do not imply excellence, competence, or maturity. They reflect
only consistency in choosing one preference over another.
9. Make sure the respondent sees the feedback session as the
beginning of the process. Knowing one’s type is not a one-time
understanding, but a guide to ongoing growth and development
toward an individual’s potential.

11. The 16 MBTI® Types
ISTJ: Quiet, serious, earns success by thoroughness and
dependability. Practical, matter-of-fact, realistic, and
responsible. Decide logically what should be done and work
toward it steadily, regardless of distractions. Take pleasure in
making everything orderly and organized – their work, their
home, their life. Value traditions and loyalty.
ISFJ: Quiet, friendly, responsible, and conscientious.
Committed and steady in meeting their obligations. Thorough,
painstaking, and accurate. Loyal, considerate, notice and
remember specifics about people who are important to them,
concerned with how others feel. Strive to create an orderly and
harmonious environment at work and at home.
INFJ: Seek meaning and connection in ideas, relationships, and
material possessions. Want to understand what motivates people
and are insightful about others. Conscientious and committed to
their firm values. Develop a clear vision about how best to
serve the common good. Organized and decisive in
implementing their vision.
INTJ: Have original minds and great drive for implementing
their ideas and achieving their goals. Quickly see patterns in
external events and develop long-range explanatory
perspectives. When committed, organize a job and carry it
through. Skeptical and independent, have high standards of
competence and performance – for themselves and others.
ISTP: Tolerant and flexible, quiet observers until a problem
appears, then act quickly to find workable solutions. Analyze
what makes things work and readily get through large amounts
of data to isolate the core of practical problems. Interested in
cause and effect, organize facts using logical principles, value
efficiency.

12. ISFP: Quiet, friendly, sensitive, and kind. Enjoy the present
moment, what’s going on around them. Like to have their own
space and to work within their own time frame. Loyal and
committed to their values and to people who are important to
them. Dislike disagreements and conflicts, do not force their
opinions or values on others.
INFP: Idealistic, loyal to their values and to people who are
important to them. Want an external life that is congruent with
their values. Curious, quick to see possibilities, can be catalysts
for implementing ideas. Seek to understand people and to help
them fulfill their potential. Adaptable, flexible, and accepting
unless a value is threatened.
INTP: Seek to develop logical explanations for everything that
interests them. Theoretical and abstract, interested more in
ideas than in social interaction. Quiet, contained, flexible, and
adaptable. Have unusual ability to focus in depth to solve
problems in their area of interest. Skeptical, sometimes critical,
always analytical.
ESTP: Flexible and tolerant, they take a pragmatic approach
focused on immediate results. Theories and conceptual
explanations bore them – they want to act energetically to solve
the problem. Focus on the here-and-now, spontaneous, enjoy
each moment that they can be active with others. Enjoy material
comforts and style. Learn best through doing.
ESFP: Outgoing, friendly, and accepting. Exuberant lovers of
life, people, and material comforts. Enjoy working with others
to make things happen. Bring common sense and a realistic
approach to their work, and make work fun. Flexible and
spontaneous, adapt readily to new people and environments.
Learn best by trying a new skill with other people.

13. ENFP: Warmly enthusiastic and imaginative. See life as full of
possibilities. Make connections between events and information
very quickly, and confidently proceed based on the patterns
they see. Want a lot of affirmation from others, and readily give
appreciation and support. Spontaneous and flexible, often rely
on their ability to improvise and their verbal fluency.
ENTP: Quick, ingenious, stimulating, alert, and outspoken.
Resourceful in solving new and challenging problems. Adept at
generating conceptual possibilities and then analyzing them
strategically. Good at reading other people. Bored by routine,
will seldom do the same thing the same way, apt to turn to one
new interest after another.
ESTJ: Practical, realistic, matter-of-fact. Decisive, quickly
move to implement decisions. Organize projects and people to
get things done, focus on getting results in the most efficient
way possible. Take care of routine details. Have a clear set of
logical standards, systematically follow them and want others to
also. Forceful in implementing their plans.
ESFJ: Warmhearted, conscientious, and cooperative. Want
harmony in their environment, work with determination to
establish it. Like to work with others to complete tasks
accurately and on time. Loyal, follow through even in small
matters. Notice what others need in their day-by-day lives and
try to provide it. Want to be appreciated for who they are and
for what they contribute.
ENFJ: Warm, empathetic, responsive, and responsible. Highly
attuned to the emotions, needs, and motivations of others. Find
potential in everyone, want to help others fulfill their potential.
May act as catalysts for individual and group growth. Loyal,
responsive to praise and criticism. Sociable, facilitate others in
a group, and provide inspiring leadership.

14. ENTJ: Frank, decisive, assume leadership readily. Quickly see
illogical and inefficient procedures and policies, develop and
implement comprehensive systems to solve organizational
problems. Enjoy long-term planning and goal setting. Usually
well informed, well-read, enjoy expanding their knowledge and
passing it on to others. Forceful in presenting their ideas.
Page 1 of 4
Beck's Depression Inventory
This depression inventory can be self-scored. The scoring scale
is at the end of the questionnaire.
1.
0 I do not feel sad.
1 I feel sad
2 I am sad all the time and I can't snap out of it.
3 I am so sad and unhappy that I can't stand it.
2.
0 I am not particularly discouraged about the future.
1 I feel discouraged about the future.
2 I feel I have nothing to look forward to.
3 I feel the future is hopeless and that things cannot improve.
3.
0 I do not feel like a failure.
1 I feel I have failed more than the average person.
2 As I look back on my life, all I can see is a lot of failures.
3 I feel I am a complete failure as a person.
4.
0 I get as much satisfaction out of things as I used to.

15. 1 I don't enjoy things the way I used to.
2 I don't get real satisfaction out of anything anymore.
3 I am dissatisfied or bored with everything.
5.
0 I don't feel particularly guilty
1 I feel guilty a good part of the time.
2 I feel quite guilty most of the time.
3 I feel guilty all of the time.
6.
0 I don't feel I am being punished.
1 I feel I may be punished.
2 I expect to be punished.
3 I feel I am being punished.
7.
0 I don't feel disappointed in myself.
1 I am disappointed in myself.
2 I am disgusted with myself.
3 I hate myself.
8.
0 I don't feel I am any worse than anybody else.
1 I am critical of myself for my weaknesses or mistakes.
2 I blame myself all the time for my faults.
3 I blame myself for everything bad that happens.
9.
0 I don't have any thoughts of killing myself.
1 I have thoughts of killing myself, but I would not carry
them out.
2 I would like to kill myself.
3 I would kill myself if I had the chance.
10.
0 I don't cry any more than usual.
1 I cry more now than I used to.
2 I cry all the time now.
3 I used to be able to cry, but now I can't cry even though
I want to.

16. Please note that this is an older edition that is for academic
purposes only. Please do not use this in clinical practice
mmdeacon
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11.
0 I am no more irritated by things than I ever was.
1 I am slightly more irritated now than usual.
2 I am quite annoyed or irritated a good deal of the time.
3 I feel irritated all the time.
12.
0 I have not lost interest in other people.
1 I am less interested in other people than I used to be.
2 I have lost most of my interest in other people.
3 I have lost all of my interest in other people.
13.
0 I make decisions about as well as I ever could.
1 I put off making decisions more than I used to.
2 I have greater difficulty in making decisions more than
I used to.
3 I can't make decisions at all anymore.
14.
0 I don't feel that I look any worse than I used to.
1 I am worried that I am looking old or unattractive.
2 I feel there are permanent changes in my appearance
that make me look
unattractive
3 I believe that I look ugly.
15.
0 I can work about as well as before.
1 It takes an extra effort to get started at doing
something.

17. 2 I have to push myself very hard to do anything.
3 I can't do any work at all.
16.
0 I can sleep as well as usual.
1 I don't sleep as well as I used to.
2 I wake up 1-2 hours earlier than usual and find it hard
to get back to sleep.
3 I wake up several hours earlier than I used to and
cannot get back to sleep.
17.
0 I don't get more tired than usual.
1 I get tired more easily than I used to.
2 I get tired from doing almost anything.
3 I am too tired to do anything.
18.
0 My appetite is no worse than usual.
1 My appetite is not as good as it used to be.
2 My appetite is much worse now.
3 I have no appetite at all anymore.
19.
0 I haven't lost much weight, if any, lately.
1 I have lost more than five pounds.
2 I have lost more than ten pounds.
3 I have lost more than fifteen pounds.
Please note that this is an older edition that is for academic
purposes only. Please do not use this in clinical practice
mmdeacon
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18. 20.
0 I am no more worried about my health than usual.
1 I am worried about physical problems like aches, pains,
upset stomach, or
constipation.
2 I am very worried about physical problems and it's hard
to think of much else.
3 I am so worried about my physical problems that I cannot
think of anything else.
21.
0 I have not noticed any recent change in my interest in
sex.
1 I am less interested in sex than I used to be.
2 I have almost no interest in sex.
3 I have lost interest in sex completely.
INTERPRETING THE BECK DEPRESSION INVENTORY
Now that you have completed the questionnaire, add up the
score for each of the twenty-one
questions by counting the number to the right of each question
you marked. The highest possible
total for the whole test would be sixty-three. This would mean
you circled number three on all
twenty-one questions. Since the lowest possible score for each
question is zero, the lowest
possible score for the test would be zero. This would mean you
circles zero on each question.
You can evaluate your depression according to the Table below.
Total Score____________________Levels of Depression
1-10____________________These ups and downs are
considered normal
11-16___________________ Mild mood disturbance

19. 17-20___________________Borderline clinical depression
21-30___________________Moderate depression
31-40___________________Severe depression
over 40__________________Extreme depression
Please note that this is an older edition that is for academic
purposes only. Please do
not use this in clinical practice
mmdeacon
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Beck Anxiety Inventory 1
Beck Anxiety Inventory
Below is a list of common symptoms of anxiety. Please
carefully read each item in the list. Indicate how much you
have been bothered by that symptom during the past month,
including today, by circling the number in the
corresponding space in the column next to each symptom.
Not At All Mildly but it
didn’t bother me
much.
Moderately - it
wasn’t pleasant at
times
Severely – it
bothered me a lot

20. Numbness or tingling 0 1 2 3
Feeling hot 0 1 2 3
Wobbliness in legs 0 1 2 3
Unable to relax 0 1 2 3
Fear of worst
happening
0 1 2 3
Dizzy or lightheaded 0 1 2 3
Heart pounding/racing 0 1 2 3
Unsteady 0 1 2 3
Terrified or afraid 0 1 2 3
Nervous 0 1 2 3
Feeling of choking 0 1 2 3
Hands trembling 0 1 2 3
Shaky / unsteady 0 1 2 3
Fear of losing control 0 1 2 3
Difficulty in breathing 0 1 2 3
Fear of dying 0 1 2 3
Scared 0 1 2 3
Indigestion 0 1 2 3
Faint / lightheaded 0 1 2 3
Face flushed 0 1 2 3
Hot/cold sweats 0 1 2 3
Column Sum
Scoring - Sum each column. Then sum the column totals to
achieve a grand score. Write that
score here ____________ .
Interpretation
A grand sum between 0 – 21 indicates very low anxiety. That is
usually a good thing. However, it is

21. possible that you might be unrealistic in either your assessment
which would be denial or that you have
learned to “mask” the symptoms commonly associated with
anxiety. Too little “anxiety” could indicate that
you are detached from yourself, others, or your environment.
A grand sum between 22 – 35 indicates moderate anxiety. Your
body is trying to tell you something. Look
for patterns as to when and why you experience the symptoms
described above. For example, if it occurs
prior to public speaking and your job requires a lot of
presentations you may want to find ways to calm
yourself before speaking or let others do some of the
presentations. You may have some conflict issues that
need to be resolved. Clearly, it is not “panic” time but you
want to find ways to manage the stress you feel.
A grand sum that exceeds 36 is a potential cause for concern.
Again, look for patterns or times when you
tend to feel the symptoms you have circled. Persistent and high
anxiety is not a sign of personal weakness or
failure. It is, however, something that needs to be proactively
treated or there could be significant impacts to
you mentally and physically. You may want to consult a
physician or counselor if the feelings persist.
This assessment is for academic purposes only. Please do not
use this in clinical practice
mmdeacon
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mmdeacon
HighlightColumn SumScoring - Sum each column. Then sum
the column totals to achieve a grand score. Write that score

22. here ____________ .Interpretation
CEFS 521
Psychological Report — Diagnostic Report Example
DIAGNOSTIC REPORT
(Example)
Client’s Name: Ann Generic
Date of Report: 01/16/2013
REFERRAL QUESTION/REASON FOR TESTING:
Mrs. Generic was referred by The Mission Group for evaluation
concerning the appropriateness of her participation in a mission
trip to rural India. The summer trip will consist of a 3-week
excursion into remote villages with a team of 10 others. Living
accommodations for the team will likely be primitive and
possibly changing with little notice.
ASSESSMENTS ADMINISTERED:
Examinee Biography
IPIP-NEO
Symptom Questionnaire (SQ)
Depression, Anxiety, and Stress Scales (DASS)
Clinical Anxiety Scale (CAS)
EXAMINEE BACKGROUND:
Mrs. Generic, a 45-year-old, married Caucasian female, works
as a secretary in a medical office. She lives with her husband
and 3 children. She is of normal height, slightly overweight, and
looks younger than her age. She dresses neatly and maintains a

23. well-groomed appearance. Mrs. Generic is very outgoing and
friendly. She has a warm smile and remained attentive during
the initial interview. She enjoys and values performing her work
to the best of her abilities. She gains a sense of pride in
accomplishing her tasks well. Her family relationships appear to
have little conflict. She reports that she, her husband, and
children generally get along well. Her outside friendships are
limited, mainly consisting of her co-workers. Mrs. Generic
reports that these friendships are not very close. Mrs. Generic
reports that she suffers from diabetes, which is successfully
managed by medication. Her obesity mildly affects her mobility
and energy levels. She recently began taking an antidepressant
under her physician’s direction. This is reportedly in response
to circumstantial mood disruptions related to her menstrual
cycle.
SUMMARY OF TEST RESULTS:IPIP-NEO
The IPIP-NEO is an assessment used to estimate a person’s
level on each of the 5 broad personality trait domains, and 30
sub-domains of the Five-Factor Model. It consists of 300 items.
Answers are provided according to a 5 point Likert-type scale.
The numerical scores represent a percentile estimate above
other subjects of the same sex and age. Scores lower than 30 for
a trait or sub-domain are characterized as “low;” scores between
30 and 70 are identified as “average;” and scores above 70 are
labeled “high.”
The following chart reports Mrs. Generic’s IPIP-NEO scores.
Extraversion
90Agreeableness
87Conscientiousness
98Neuroticism
16
Openness to Experience
7

24. Friendliness
98
Trust
33
Self-Efficacy
93
Anxiety
5
Imagination
1
Gregariousness
91
Morality
93
Orderliness
94
Anger
34
Artistic Interest
10
Assertiveness
87
Altruism
93
Dutifulness
83
Depression
6
Emotionality
64
Activity Level
49
Cooperation
67
Achievement-Striving
97

25. Self-Consciousness
8
Adventurousness
34
Excitement-Seeking
38
Modesty
79
Self-Discipline
96
Immoderation
99
Intellect
22
Cheerfulness
91
Sympathy
84
Cautiousness
76
Vulnerability
5
Liberalism
8
Symptom Questionnaire (SQ)
The SQ is a 92-item instrument for measuring four aspects of
psychopathology: depression, anxiety, somatization, and anger-
hostility. Subjects respond to a descriptive word or phrase with
true/false and yes/no answers. Mrs. Generic’s score was 6 on
the relaxation component of the anxiety/relaxed sub-scale,
which was above average compared with the non-clinical
sample. Her score was 5 for the depression/contented sub-scale,
reflecting that she compared with the average of the non-
clinical sample. Mrs. Generic’s score of 7 for the
somatic/somatic well-being sub-scale was slightly above
average for the clinical sample. Her score of 7 on the

26. hostility/friendly sub-scale was slightly above the non-clinical
sample mean for the friendly component.
Depression, Anxiety, and Stress Scales (DASS)
The DASS is a 42-item instrument that measures depression,
anxiety, and stress within the past week prior to its
administration. Each scale is composed of 14 primary
symptoms. Subjects respond to statements on a 4 point Likert-
type scale according to the degree to which that statement was
experienced. Mrs. Generic’s depression and anxiety scores
were well below the mean for the non-clinical samples, 2 and 1
respectively. Her score of 13 for the stress sub-scale was
elevated for the non-clinical sample, but compared far below
the average of the clinical sample.
Clinical Anxiety Scale (CAS)
The CAS is a 25-item instrument that measures the degree of
clinical anxiety. Higher scores indicate increased anxiety. This
instrument has a clinical cutoff score of 30 (+5). Mrs. Generic’s
score was 18.
PSYCHOLOGICAL IMPRESSIONS:
Mrs. Generic is a friendly, outgoing person. She is verbally
expressive, and has a rich vocabulary. She is open, cooperative,
and capable of interacting with others in a socially appropriate
manner. She views herself as genuinely caring, responsible, and
friendly.
Mrs. Generic is internally motivated and guided by her
Christian faith. External motivation stems from her extraverted
personality. She prefers to be in the company of others and
finds extended time alone emotionally difficult. She values
actions of service toward others. She enjoys helping others and
offering support to those with physical needs. This should make
her an asset to the mission team.

27. Results of the IPIP-NEO (Extraversion, Agreeableness, and
Neuroticism domains), the SQ (Depression, Anxiety, and Anger-
Hostility sub-scales), the DASS (Depression and Anxiety sub-
scales), and the CAS (Anxiety scale) support that Mrs. Generic
is generally extraverted, suggests that she enjoys new social
settings, and that her life is not greatly hindered by depression
or anxiety.
She is likely to express a positive mood and enthusiasm that is
encouraging to those around her. She seems to be an agreeable
individual who is considerate of others and values group
harmony. She finds interpersonal conflict more difficult to
manage than environmental stressors. She may also easily feel
intimidated by others and adopt a passive stance when faced
with conflictual situations.
She is relatively free of depression and anxiety and is likely to
maintain a sense of emotional stability and calmness even in
challenging environments. This is supported by the results of
the SQ (Anxiety/Relaxed and Depression/Contented sub-scales),
the DASS (Depression and Anxiety sub-scales), and the CAS
(Depression and Anxiety scales).
Her level of emotional reactivity is low indicating that she may
possess personal resources that allow her to effectively cope
with stressful situations. Mrs. Generic tends to be calm and able
to regulate her emotions. She is not adverse to adventurous
activities, which indicates that Mrs. Generic may be reasonably
comfortable with the unfamiliar conditions involved in an
environment as might be expected on the mission trip.
Her unusually high score on the Neuroticism (Immoderation
sub-domain) of the IPIP-NEO suggests that Mrs. Generic has
difficulty resisting some cravings and urges. This was
consistent with information gathered during the initial

28. interview, wherein Mrs. Generic reported she has difficulty
controlling her eating habits. This appears to be constrained to
that aspect of her life; otherwise, she reports an organized and
disciplined existence.
Mrs. Generic scored slightly above the average of the clinical
sample on the SQ (Somatic/Somatic Well-Being sub-scale). This
may be explained as Mrs. Generic reported experiencing
numerous and chronic physical complaints related to obesity,
hypothyroidism, and diabetes. She indicated that her physical
complaints have basis in medically verified physical conditions.
The elevated score on the DASS (Stress sub-scale) is indicative
of situational stressors of the past week. Affecting this score
may be that Mrs. Generic reports she has experienced
menstruation during the past week and typically notes increased
irritability and feelings of being stressed associated with this
event.
CONCLUSIONS AND RECOMMENDATIONS:
Mrs. Generic is a 45-year-old female who was referred for
evaluation concerning her appropriateness for participation in a
mission trip to a challenging environment. She is married with 3
children and is employed as a secretary at a medical office.
Mrs. Generic was provided with a battery of psychological
assessments, which included the Examinee Biography, IPIP-
NEO, Symptom Questionnaire (SQ), Depression, Anxiety, and
Stress Scales (DASS), and the Clinical Anxiety Scale (CAS).
Based on the results of the assessments, it is the conclusion of
this examiner that Mrs. Generic is an acceptable candidate for
participation in the mission trip for the following reasons:
a) Mrs. Generic possesses personal qualities that will support
her adaptation to the challenging mission environment and

29. participation on the mission team.
b) Mrs. Generic is not unduly encumbered by anxious or
depressive conditions that would be heightened by the
challenging mission environment.
c) Mrs. Generic is likely to engage positively with the mission
team in a mutually beneficial relationship.
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