blocked psychological report on gm - (wais, wms)
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Psychological Report
DISCLAIMER: This report and its contents are confidential. Its purpose is for the benefit of the client and its disclosure should be restricted to individuals directly connected to the case who have a current authorization and have knowledge about Psychological Evaluation. Its re-disclosure is strictly prohibited.
Examinee and Testing Information
Examinee Name GM G. Minor Date of Report 10/1/2011
Date of Birth 12/1/1990 Handedness Right
Sex Female First Language English
Race/Ethnicity Asian Marital Status Single
Grade Junior Examiner Lauren Shapiro
Test Administered
WAIS-IV 9/24/2011 Age at Testing: 20 years 9 months Retest? NoWMS-IV 9/24/2011 Age at Testing; 20 years 9 months Retest? No
Reason for Referral
This evaluation was requested to provide GM with information regarding her intelligence, cognitive and memory functioning.
Background Information
GM is a 20 year old Korean American female who is single and living with her parents in
Indio, California1. She is currently enrolled in College of the Desert to obtain her
Bachelor's degree in Business and works part-time at Unknown Seafood Restaurant as a
hostess. She described recently moved back home after attending California State
University Fullerton for two years. She reports having a happy childhood despite her
biological father abandoning her mother when she was 2 months old. Although she
1 For the sake of brevity and without any disrespect intended, GM is referred to by her first name for the remainder of the report.Page 1 of 13
recounts having a strong and healthy relationship with her mother and stepfather, GM
admits that for many years she resented her mother for being absent as she was a
single-mom working two jobs. Moreover, GM reported that as a child, she felt overly-
protected by and clashed with her mother who is a devout Christian with very traditional
Korean values. GM is a very friendly, outgoing person who appears to be a people-
pleaser. She attributes her personality and wide social circle to being frequently
uprooted as a child, which required her to start afresh at many schools. Despite being an
only child, GM doesn't recall feeling lonely as a child and instead believes that it helped
her learn to be independent and self-sufficient at an early age. GM recounts having many
friends in her early childhood and adolescence but to her recollection the quality of these
relationships were very shallow. This pattern in her relationships has apparently carried
over to her dating experiences as she conceded to a history of promiscuity and
superficial relationships. GM disclosed an extensive history of drug, tobacco and alcohol
use. To her recollection, GM began smoking marijuana as a sophomore in high school.
Until moving back to her parents' home in Indio, she smoked a bowl or joint daily. In
addition, GM admitted to trying cocaine as a sophomore at CSUF. Over the last two
years, she has snorted anywhere between 1 to 3 lines on six or seven occasions.
Although GM denies dependency on any of these drugs or alcohol, she said that her
drinking was a concern at several points throughout her last years of college where she
had an extensive history of blacking out after a night of heavy drinking. GM denies
having a history of mental illness or depression and suicidal or homicidal ideations;
however, she reports recent feelings of loss of self control, bouts of crying and having
difficulty concentrating but has attributed these changes to her step-father's recent
diagnosis of Leukemia which prompted her to transfer schools and move back in with her
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parents. Despite these struggles, GM says that she is happy and healthy and looking
forward to a possible transfer to biology.
Test Behavior and Mental Status
GM arrived on time for the test unaccompanied. GM appeared to be of stated age,
casually and neatly dressed and in no state of distress. The client engaged with the
examiner in a cooperative and friendly manner. The client demonstrated good eye
contact. Her speech was spontaneous with normal rate, rhythm and tone. Her responses
to questions were appropriate and well-reasoned. Her affect and mood were situation-
appropriate; however, she did appear to be somewhat anxious about her test results.
Emotionally, she appears to view the world as a happy, optimistic place. GM indicated
that she was not depressed and had no suicidal or homicidal ideations. Her thoughts
were logical, relevant and coherent with no signs of abnormality. Her thought content
did not reveal any delusional ideations, hallucinations, ideas of reference, obsessions or
compulsions. She was alert and oriented to person, place, time and situation. Her
memory was intact but her attention and concentration were poor. GM demonstrated
boredom during testing and indicated she was anxious to finish quickly. Furthermore,
she kept requesting to draw on blank papers and testing materials. This observed
boredom seemingly translated into distraction and may have moderately interfered with
her ability to perform at her full potential. GM's test behavior was somewhat
argumentative. Furthermore, she accused the examiner of treating her like a baby whilst
giving instructions as required by the manual, "I get it, move on". GM demonstrated
difficulty with serial 7s, a numeric sequencing task, having made 2 errors which suggests
a difficulty in concentration. Throughout testing, GM was preoccupied with scoring and
her results, periodically asking "how am I doing" and "I got that wrong didn’t I". During
the Design I and II subtests GM named the design cards objects (ex: a design that
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entailed wavy lines was called "beach"). Therefore, her intelligence was estimated to be
above average; consistent with her level of education.
Tests Administered
WAIS-IV Scale Score WMS-IV Scale Score
Verbal Comprehension 122 Auditory Memory 124
Perceptual Reasoning 123 Visual Memory 130
Working Memory 136 Visual Working Memory 126
Processing Speed 135 Immediate Memory 123
Full Scale 128 Delayed Memory 137
Interpretation of WAIS-IV Results
General Intellectual Ability
The Wechsler Adult Intelligence Scale-IV (WAIS-IV) is a comprehensive assessment of
verbal and non-verbal cognitive ability assessing vocabulary, abstract reasoning ,
perceptual-motor reasoning, problem solving and several aspects of memory. GM
achieved superiorly on the Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV).
GM's level of intelligence exceeds approximately 97% of her peers (FSIQ = 128;
confidence interval = 123-132). GM's results demonstrate a strength on the verbal
comprehension, perceptual reasoning and processing speed tasks but a relative
weakness on the working memory tasks.
Verbal Comprehension
GM's verbal reasoning abilities as measured by the Verbal Comprehension Index (VCI)
were in the superior range and above those of approximately 93% of her peers (VCI =
122; 95% confidence interval = 115-127). The VCI was designed to assess verbal
reasoning, abstract reasoning and concept formation. GM achieved her best
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performance of the VCI on the Similarities subtest but performed consistently and
averagely on the Vocabulary, Information and Comprehension subtests.
The Similarities subtest required GM to reason abstractly by identifying the similarities
between two items. The Information subtest required GM to answer questions based on
general knowledge acquired over the course of her life. The Vocabulary subtest required
GM to define certain items based on previous learning. The Comprehension subtest
required GM to explain abstract concepts reflecting social conventions, rules and
expressions.
Perceptual Reasoning
GM's nonverbal reasoning abilities as measured by the Perceptual Reasoning Index (PRI)
were in the superior range and above those of approximately 94% of her peers (PRI =
123; 95% confidence interval = 116-128). The PRI was designed to assess fluid
reasoning in the perceptual realm with tasks that measured nonverbal concept
formation, visual perception organization, spatial reasoning and visual-motor
coordination. GM's performance on the perceptual reasoning subtests that contributed to
the PRI are fairly variable but within normal limits. An examination of her individual
subtest results suggest that GM has above average spatial reasoning abilities as
demonstrated on the Block Design, Matrix Reasoning, Visual Puzzles and Picture
Completion tasks but a relative weakness for Figure Weight tasks which measure
mathematical and deductive reasoning.
The Block Design subtest required GM to arrange colored blocks according to a visual
prompt. The Matrix Reasoning subtest required GM to identify the missing design that
completes a pattern from multiple designs. The Picture Completion subtest required GM
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to examine a picture and identify the missing element or detail that was absent from the
picture. The Visual Puzzles subtest required GM to identify which grouping of objects
creates the visual prompts. The Figure Weights subtest required GM to identify which
grouping of objects balances out the visual equation.
Working Memory
GM's ability to sustain attention, concentration and exert mental control as measured by
the Working Memory Index (WMI) was in the average range and above those of
approximately 63% of her peers (WMI = 105; 95% confidence interval = 98-111). The
WMI was designed to assess working memory through tasks of concentration and
attention. GM's abilities to sustain attention, concentration and exert mental control are
a weakness relative to her vocabulary comprehension, perceptual reasoning and
processing speed abilities. GM's subtest results were consistently average and indicated
a slight strength at completing mental arithmetic tasks, as found in the Arithmetic
subtest, over tasks that involved holding and sequencing numbers and letters in her
mind, as found in the Digit Span and Letter-Number Sequencing subtests.
The Arithmetic subtest required GM to solve oral arithmetic problems. The Letter-
Number Sequencing subtest required GM to sequence letters and numbers that were
recited orally. The Digit Span subtest required GM to repeat a set of numbers in a
specific order after an oral recitation.
Processing Speed
GM's ability to complete problems and reason quickly without making errors as
measured by the Processing Speed Index (PSI) was in the very superior range and above
those of approximately 99% of her peers (WMI = 135; 95% confidence interval = 123-
140). The PSI was designed to assess visual discrimination, attention to detail, fine-motor
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skill coordination, short-term memory and learning ability. GM demonstrated
considerable and consistent strengths in these domains as indicated by her superior
Symbol Search, Coding and Cancellation subtest scores.
The Symbol Search subtest required GM to identify a symbol within a set of symbols. The
Coding subtest required GM to recode a series of numbers with a predetermined series
of symbols. The Cancellation subtest required GM to ignore distracting stimuli while
marking a specific combination of colors and shapes.
Interpretation of WMS-IV Results
GM was administered 10 subtests of the Wechsler Memory Scale-IV (WMS-IV). When
interpreting GM's performance on the WMS-IV, it is important to note any factors that
may affect her test performance. GM experienced difficulties staying focused and paying
attention during testing, which may have contributed to a diminished concentration and
incapability to follow instructions and demonstrate her true abilities.
Auditory Memory
GM's ability to process oral information, repeat it immediately and then recall the
information after a 20-30 minute delay as measured by the Auditory Memory Index (AMI)
was in the superior range and above those of approximately 95% of her peers (AMI =
124; 95% confidence interval = 117-129).
Within auditory memory, GM exhibited very superior strength on the Logical Memory II
subtest relative to her weaker Logical Memory I, Verbal Paired Associates I and Verbal
Paired Associates II scores. On Logical Memory I, GM was told a story and was asked to
recall specific details immediately after its conclusion. Meanwhile, on Logical Memory II,
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GM was asked to recall specific details from the story that were relayed 22 minutes prior.
This subtest measures GM's ability to recall verbal information that follows a central
theme. Meanwhile, the Verbal Paired Associates I (VPAI) subtest required GM to recall
novel word pairs as well as meaningful word pairs. The Verbal Paired Associates II (VPAII)
subtest required GM to recall these word pairs, both novel and meaningful, after a 26
minute delay. The VPAI subtest measures immediate learning of verbal associations over
multiple exposures while the VPAII subtest measures delayed cued recall for word pairs.
Visual Memory
GM's ability to process visual details and reason abstractly as measured by the Visual
Memory Index (VMI) were in the very superior range and above those of approximately
98% of her peers (VMI = 130; 95% confidence interval = 123-134).
Within visual memory, GM exhibited a strength on the Visual Reproduction II subtest;
however, her scores on the Visual Reproduction I, Design I and Design II subtests were
consistent and above average. The Visual Reproduction II subtest required GM to recall
designs she had previously seen and drawn and after 28 minutes, to freely recall and
reproduce them without any visual cues. Meanwhile, the Visual Reproduction I subtest
requires GM to recall and draw designs immediately after viewing them. The Designs I
subtest required GM to view a grid with 4-8 designs cards and recall the correct location
and card details in spite of distractors cards. The Designs II subtest required GM to recall
the correct design details and spatial location of the cards on the grid after a 24 minute
delay without any visual cues.
Visual Working Memory
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GM's ability to temporarily hold and manipulate spatial positioning and visual aspects as
measured by the Visual Working Memory Index (VWMI) was in the superior range and
above approximately 96% of her peers (VWMI = 126; 95% confidence interval = 117-
131).
It is important to note that GM's attentional difficulties observed throughout the
assessment period are believed to have affected her ability to express her true capacity
on these tasks. Despite her lack of focus and concentration, GM performed superiorly on
the Symbol Span task but averagely on the Spatial Addition task and her scores on this
subtest might have been higher had these difficulties not been present.
GM's performance on the Symbol Span was significantly better than her performance on
the Spatial Addition subtest which suggests that her visual working memory functioning
is subject to marked variability. The Spatial Addition subtest assesses spatial working
memory and requires storing and manipulating information while ignoring distracting
stimuli. Meanwhile, the Symbol Span required GM to retain a mental image of each
symbol and its relative spatial location on a grid. The discrepancy between Symbol Span
and Spatial Addition points to GM's inability to ignore distracting stimuli and may be
attributed to her attentional difficulties.
Immediate Memory
GM's immediate verbal and visual recall abilities as measured by the Immediate Memory
Index (IMI) were in the superior range and above those of approximately 94% of her
peers (IMI = 123; 95% confidence interval = 116-128).
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Within immediate memory, GM exhibited a relative weakness on the Verbal Paired
Associates I subtest in comparison to her consistent and above average scores on the
Logical Memory I, Design I and Visual Reproduction I subtests. As previously mentioned,
the Verbal Paired Associates I subtest measures immediate learning of verbal
associations over multiple exposures while the Logical Memory I subtest measures
immediate recall of specific details from a narrative after one single exposure. The
Designs I subtest required GM to recall design cards and their spatial location on a grid
immediately after exposure while the Visual Reproduction I subtest required GM to
reproduce drawings immediately after viewing them.
Delayed Memory
GM's delayed verbal and visual recall abilities as measured by the Delayed Memory
Index (DMI) were in the very superior range and above those of approximately 99% of
her peers (DMI = 137; 95% confidence interval = 128-142).
Within delayed memory, GM exhibited a relative strength on Logical Memory II subtest in
comparison to her consistent and above average scores on the Verbal Paired Associates
II, Design II and Visual Reproduction II subtests. As previously mentioned the Logical
Memory II subtest required GM to recall specific details from a story after a delay while
the Verbal Paired Associates II subtest required GM to recall both unique and meaningful
word pairs after a delay. The Visual Reproduction II subtest required GM to recall
previously viewed designs and, after a delay, to redraw them without visual prompts
while the Designs II subtest required GM to recall designs cards and their spatial location
on a grid after a delay.
Summary of Intellectual and Memory AbilitiesPage 10 of 13
A comparison of GM's auditory memory ability (AMI) to her results on the WAIS-IV
revealed that tasks involving auditory information do not pose a challenge to GM.
Information presented orally, such as a story, word pairs, letters or numbers, were easily
repeated or recalled without prompts or cues.
A comparison of GM's visual memory ability (VMI) to her results on the WAIS-IV revealed
that tasks involving visual perception were performed superiorly. Tasks involving
recalling specific details from visual prompts, reproducing diagrams from visual prompts,
spatial reasoning and visual problem solving, appear to come naturally to GM.
A comparison of GM's visual working memory ability (VWMI) to her results on the WAIS-IV
revealed that she has very superior ability to manipulate visual information while holding
it in immediate memory. Subtests on both the WMS-IV and WAIS-IV that required
manipulation of visual information required GM to recall specific details, designs and
symbols and identify their spatial location and patterns.
DSM Diagnosis
AXIS I 304.80 Polysubstance Abuse (remission)ADD/ADHD (provisional)
AXIS II No diagnosisAXIS III No medical conditions reported
AXIS IV Indicates stress and emotional instability due to father's recent Leukemia diagnosis
AXIS V75 (Sept, 2011) 85 (April, 2011)
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Discussion and Summary
Given her superior scoring, GM's test results revealed a marked discrepancy between
her working memory and her vocabulary comprehension, processing speed and
perceptual reasoning abilities. GM reported an extensive mental health and substance
abuse history. As a result, the incongruity between the indices suggests that her inability
to hold and maintain thoughts might be attributed to her past substance abuse.
In conjunction with her lack of focus, inability to concentrate and high distractibility, her
low working memory index scores suggests that GM may have attention and
concentration difficulties. Inability to do serial 7s, a simple sequencing task, suggests
that GM has difficulty with concentration. Furthermore, throughout testing, GM appeared
to be bored, was easily distracted and frequently requested to draw. As such, GM should
be referred to her general practitioner for further testing and to rule out the possibility of
an ADD/ADHD diagnosis.
Despite her distractibility, GM demonstrates strong delay recall as indicated by the
Logical Memory II and Visual Reproduction II subtests. This suggests that her history of
drug abuse and potential attention difficulties might be interfering with her ability to
immediately process information but do not affect her ability to recognize or recall
details and facts that have been stored in long term memory.
It is also important to note that during the background interview, GM reported feeling as
though her mother was overly-protective during her childhood; however, during testing,
GM was argumentative and accused the examiner of babying her whilst giving the test
instructions. This suggests that GM disregards authority and has trouble accepting
instruction and directions.
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Recommendations
Psychological testing is probabilistic and inferential by its nature and provides
hypotheses that should be explored with data from clinical interviews and other sources.
Conclusions about an individual are not reached on the basis of psychological testing
alone. Application of these instruments to the understanding of the individual must take
into consideration the person's history, clinical presentation, present life circumstances,
and other pertinent information. These tests results are only an estimate of GM's true
cognitive and memory functioning. In all likelihood, if these tests were administered on
alternative day under different circumstances, the obtained scores may be somewhat
discrepant from the ones detailed in this report.
1) Rule out ADD/ADHD - GM should be referred to her general practitioner for possible
attention and concentration difficulties.
2) Rule out anxiety and depression
3) Rule out substance abuse or relapse
4) Additional testing to clarify the nature of the discrepancy between her average
working memory scores and her obvious higher potential in other areas.
5) Based on her superior cognitive functioning and memory abilities, GM appears to be a
good candidate for higher education and should she desire to pursue such studies, would
be expected to succeed.
6) GM should attempt to improve her working memory through memory card games, the
creation and memorization of lists, and by removing all distractions from immediate
area.
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