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Handbook of Psychological Assessment 2ed - Gary Groth-marnat

Handbook of Psychological Assessment 2ed - Gary Groth-marnat

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Anxiety (Scale A)

High scores indicate clients are complaining of tension, difficulty relaxing, indecisive-
ness, and apprehension. Additional complaints include a highly sensitive startle re-
sponse, hyperalertness, and fears related to the onset of poorly defined difficulties.
Physiological complaints related to overarousal are also common. These might include
insomnia, headaches, nausea, cold sweats, upset stomach, palpitations, excessive per-
spiration, and muscular aches. Anxiety may be either generalized or more focused, as
in social situations or specific phobias. Inspection of responses to individual scale
items can help to assess the degree of specificity of the anxiety.

Somatoform (Scale H)

Elevations reflect somatic complaints expressed in areas such as generalized pain, fa-
tigue, multiple vague complaints, and/or preoccupation with health-related difficul-
ties. However, these typically represent psychological conflicts that are being
expressed through physical means. If the clients have legitimate physical illnesses, they
are likely to be unduly preoccupied and possibly exaggerating their difficulties. In
other words, their difficulties are overinterpreted to signify a major illness when the
illness is actually relatively minor. Often, the complaints are expressed in a dramatic
and/or vague manner. An important function of these complaints is to gain sympathy,
attention, or medical reassurance. A careful medical history typically reveals a
hypochondriacal pattern in which they are overusers of the health care system.

Bipolar: Manic (Scale N)

High scorers are likely to have mood swings that range from elation to depression.
When elated, they are restless and distractible, have an exaggerated sense of self-
esteem, and are overly optimistic and impulsive. They have a heightened and general
sense of enthusiasm, along with unrealistic goals. Interpersonal relationships have a
demanding, intrusive, and pressured quality. There is a reduced need for sleep, erratic

352Millon Clinical Multiaxial Inventory

mood shifts, and flighty ideas. Extreme elevations indicate a psychotic process charac-
terized by delusions and possibly hallucinations.

Dysthymia (Scale D)

Elevations on Dysthymia reflect sadness, pessimism, hopelessness, apathy, low self-
esteem, and guilt. These persons continuously feel socially awkward, introverted, sad,
useless, and filled with self-doubt. Discouragement and a preoccupation with their
own inadequacy are also present. They have a sense of futility and may easily break
into tears. Somatic complications might include insomnia, a poor appetite or habitual
overeating, poor concentration, a continuous sense of feeling tired, and a marked loss
ofinterest in pleasurable activities. Although they may have reduced effectiveness in
competently undertaking daily activities, they still remain involved in everyday life.
Suicidal ideation might be present and should be investigated further. This, and other
details related to the nature of the depression, can be further understood by noting the
responses to particular items. Unless the Major Depression scale is markedly ele-
vated,itis unlikely that the depression will be sufficiently severe to be considered

Alcohol Dependence (Scale B)

Individuals scoring high on Alcohol Dependence are likely to have had a history of
problem drinking. They may have tried to unsuccessfully curb or discontinue their
drinking. High scorers are also likely to be having social, family, and/or occupational
distress. However, the degree to which their drinking is problematic needs to be as-
sessed in relation to other information on their level of functioning.

Drug Dependence (Scale T)

High scorers will have had a recurring history of difficulties with drug abuse. Also
present are a number of traits associated with drug-related difficulties: hedonism,
impulsiveness, difficulty conforming to mainstream standards of behavior, self-
indulgence, exploitiveness, and narcissistic personality characteristics. High scorers
are likely to have difficulty organizing daily life activities and experience social, fam-
ily, legal, and/or occupational distress.

Posttraumatic Distress Disorder (Scale R)

Elevations on this scale suggest that these individuals have experienced an intense life-
threatening event that has resulted in extreme fear, helplessness, and arousal. They
have reacted by having uncontrolled, intrusive, and recurrent images or emotions re-
lated to the event(s): flashbacks, nightmares, or dissociative feelings that reactivate
the event(s). Anxiety-related symptoms might include hypervigilance, hyperalertness,
overreactivestartle reactions, and a compulsive avoidance of circumstances that might
be related to the trauma.

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