A Psychiatric Evaluation on May 19, 2006 by Barbara Wynter, License psychologist who is
Clinical administrator of Central Treatment Facility ward 1, 2, 3, was requested to further assist in diagnosis.
LIMITS OF CONFIDENTIALITY:
DR, B. Wynters
MMPI (Spell out the name Minnesota Multiphasic Personality Inventory)
Is a depressive component of scale 6. The items connote extraordinary emotional sensitivity or vulnerability that is dysphonic in tone. These items have a "poor little me" flavor, portraying the self as meek and innocuous, emotionally fragile, incapable of being a threat to others, and perhaps as being entitle to special concern and consideration for one's tender sensibilities. There is an implicit theme of resentment and lack of forgiveness; however, a high scores nurse grudges and are view as injustice collectors.
The raw score on Disclosure (X) shows less than 178; therefore, this profile is valid.
Debasement (Z) BR 75 suggests a tendency to deprecate and devalue oneself, as well as exaggerate one's degree of symptoms.
High scores on the Clinical Personality Patterns: AXIS II
1 Schizoid (101): This is showing a severe pattern of social and interpersonal detachment with restricted emotions. Therefore, this client is described as withdrawn, aloof, distant and listless. Neither desire nor enjoys close relationships, including being part of family. This would explain his history of domestic violence and prostituting.
2A. Avoidant (78): Again, the client is showing a pattern of withdrawn, self-inadequacy, and hypersensitive to criticism. He is monosyllabic, vague, and circumstantial. Initially, he may appear suspicious, paranoid or anxious.
3 Dependent (76) -- This score is showing clinging behavior in search of nurturance and security; therefore, he can be passive, submissive, and feel inadequate. This type of personality patterns willingly submits to the wishes of others to maintain their protective benefits. This would also explain why scale C (Borderline is high) (This would explain his behavior of living with his brother, then being evicted and moving with his girlfriend)
8B Masochistic (88) - This score is showing that the client is suffering from low self-esteem, depression, and an inability to enjoy his successes or life experience (Lebe, 1997) This can reflect problematic behavior patterns, which are not in the best interest of the client.
High scores on the Severe Personality Pathology: AXIS II
S. Schizotypal (91) -- This scale is indicating (High scoring present) emotionally bland with flat affect or with an anxious wariness. This demonstrate that the client prefer to be alone and actually experience discomfort within personal relationship (Othmer & Othmer, 1994)
If anxiety is present, it is usually diffuse and associated with fear of loss and abandonment.
C. Borderline (78) The high score in this scale is indicating that the client show attachment disorders with patterns of intense but unstable relationships, labile emotions, a history of impulsive behaviors, and strong dependency needs with fears of abandonment (MCMI-III, Robert J. Craig, p 27)
P. Paranoid (84) - The perceive high score in this scale is indicating that the client can be vigilantly mistrustful and often that people are trying to control or influence them in malevolent ways. They are characteristically abrasive, irritable, hostile, and irascible, and may also become belligerent if provoked. (MCMI-III, Robert J. Craig, p 27)
High Score on the Clinical Syndromes Scales: AXIS I
A. Anxiety (88) High score on this scale is suggesting that the client has symptom associated with physiological arousal. They would be described as anxious, apprehensive, restless, and unable to relax, edgy, jittery, and indecisive
(MCMI-III, Robert J. Craig, p 29)
D Dysthymia (85) - this scale is suggesting that the client has symptom associated with depression. Scoring high on this scale is behaviorally apathetic, socially withdrawn, feel guilty, pessimistic, discouraged, and preoccupied with feelings of personal inadequacy. They have low self- esteem and utter self- deprecatory statements, feel worthless, and are persistently sad. They have many self- doubts and show introverted behavior.
(MCMI-III, Robert J. Craig, p 31)
R Post-Traumatic Stress (79) - High- scoring patients are reporting symptoms that might include distressing and intrusive thoughts, flashbacks, startle responses, emotional numbing, problems in anger management, difficulties with sleep or with concentration, and psychological distress upon exposure to people, places, or events that resemble some aspect of the traumatic event.
(MCMI-III, Robert J. Craig, p 33)
High Score on the Severe Clinical Syndromes Scales: AXIS I
CC. Major Depression (97) High- scoring patients may be unable to manage their day- to- day activities. They are severely depressed, with feelings of worthlessness and vegetative symptoms of depression (e.g., loss of energy, appetite, and weight; sleep disturbances; fatigue; loss of sexual drive or desire). Suicidal ideation may be present.
(MCMI-III, Robert J. Craig, p 34-35)
BEHAVIORAL OBSERVATION AND MENTAL STATUS EVALUATION:
1. Hygiene and Grooming
2. Mood and Affect
3. Appearance and Attitude
4. Insight and judgment, Cognitive
5. Thought Process, Thought Content, and Perception
6. Normal Posture
7. Stitches in nose from injury on May 20, 2006
8. No abnormal move
9. Non-Psychotic features
10. Alert and oriented x3
11. Identity memory reasoning, abstract intact
12. Client reported no medical problem; however, he reported that he has Hepatitis C from a hooker and seizures (in quote).
13. The client reported no psychiatric acute distress; however, some emotional problems. He also reported having anger problems and depression.
14. He also reported not having high stress past and present
15. No anxiety; however, in quote, "PTSD" (Rape on July 2003)
16. He gets Nightmares, "Paranoid" suspicious of others. Denied experience of any other symptoms.
17. Mr. Chicago's emotion is appropriate at times; however, inpatient and some irritable at times.
18. Speech is normal and coherent.
19. No AH, VH, in the past from delusion of being rape
20. Delusion of thought control (Voices command to kill the victim)
21. Mr. Chicago is paranoid (people rape him, thinking his Adam's apple moved down
22. Election insight, Tupo chicord, SOMETHING ABOUT KILLING TUPAC
23. Mexican moving in my basement.
24. Mr. Chicago has no insight into his mental disorder only on substances abuse. Denied psychotic symptoms
25. Denied SI, HI
The following information was obtained through clinical interviews with Joe Chicago:
1. Intimate relationship: The pt reported that he's never been married and has no children's.
2. He was 14 years old when he had his first sexual encounter. Over the course of his life time, he estimated that he slept with 10 partners. He reported that they are all females. He stated that he is exclusively heterosexual and denied ever experiencing with homosexual behaviors. In addition, he denied ever engaging in prostitution. His longest interment relationship lasted one year.
3. Mr. Chicago was born and raised in Washington D.C. area. His parents' divorce in 1998. He is the youngest of five (5) children's (1 brother and 3 sisters).
4. Sibling: Work: Intern, unknown place of employment in New York
5. 3 siblings teaches other is interns in NYC
6. CTF: Admitted in the beginning
7. Hospital records
8. Father die of a stroke 2002
9. Mother work at Starbucks
10. Mr. Chicago attended many school
11. Failing grades throughout his education
12. Discharge from juvenile detention at 18y/o birthday
13. Got GED
14. Attended Montgomery Jr. College for 2 semesters. He reported that on the Core classes he received grade A. However, records states that he fails college due to unknown reasons
15. Highest education 9th education
16. Suspended and expel numerous occasion
17. Alternative school for boys (special education) for conduct. He had fights with his peers. He beat someone at 14 years old and put that person in hospital.
18. Suspended and expelled for conduct distort disorder and attended special education classes
19. Mr. Chicago is a 24-year-old Single Caucasian Male with a history of psychiatric and legal issues, a history of violence, Substance Abuse and Poor academic performance.
20. Mr. Chicago reported that in the past he experience psychotic symptoms (Auditory and visual Hallucinations) with delusions that he was being rape by numerous people in the past.
21. Furthermore, he shows to have some delusions of thought control such as command hallucinations (Voices would command him to kill the victim from the incident of offend he would become that victim).
Mr. Chicago is a client on a maximal security inpatient service division of the Central Treatment in District of Columbia. He was admitted on September 9, 2004, by order of the Superior Court District of Columbia after not being adjudicated for reason of insanity and not guilty on charge of Second Degree Murder. Previously, he was admitted at Central Treatment Facility on March 2004 for competency to stand trial. Instant offense (second degree murder)
Mr. Joe Chicago is outgoing and sociable and has a robust need to…