ID : 005012 Sex : MALE
Age: 12 Grade: 9th Grade
Interview Date: August 17, 2004 Interview Time: Not Available

DISC Predictive Scales (DPS) Summary Report

Health Information

Clinically Significant Information

Vision Problems.......... YES
Vision Problems.......... YES
Hearing Problems.......... YES
Hearing Problems.......... YES
Dental Problems.......... YES
Dental Problems.......... YES
Rule Out OCD ("Likes To" - Q16).......... YES
Rule Out OCD ("Likes To" - Q16).......... YES
Suicide Ideation (past 3 months).......... YES
Suicide Ideation (past 3 months).......... YES
Suicide Attempt (last year).......... NO
Suicide Attempt (last year).......... NO
Seen Professional .......... NO
Seen Professional .......... NO

Symptom Scale

Impairment Scale

Present (meets DPS criteria)
Social Phobia
Social Phobia
Panic Disorder
Panic Disorder
Generalized Anxiety
Generalized Anxiety
ObsessiveCompulsive Disorder
ObsessiveCompulsive Disorder
Depression
Depression
Alcohol Use
Alcohol Use
Marijuana Use
Marijuana Use
Other Substance Use
Other Substance Use
Status
PRESENT
PRESENT
Symptom Area
Feeling Anxious or Worried
Feeling Sad or Depressed

Total DPS Symptom Score: 25

Total DPS Impairment Score: 13

Clinical Evaluation Is Indicated When:

  • Either of the suicide items have been endorsed ( "Clinically Significant Information" above) OR ...
  • A Specific Disorder is 'PRESENT' in Symptom Scale AND the Total DPS Impairment Score >= 6 * OR ...
  • The Total DPS Symptom Score >= 9

    * Impairment need not be taken into account for alcohol, marijuana or other substances.

    NOTE: The DPS is a screen, and is not diagnostic. It is not a substitute for a thorough clinical evaluation.



    DPS Symptom Scale Reconstruction


    Demographics
    Question Answer Score
    D1 Are you male or female? MALE 1
    D3 How old are you? (Press the [ENTER] key to continue.) 12
    D3 Are you Hispanic or Latino? YES 1
    D4 Choose the category that best describes your race: White 1
    D5 What grade are you in? 9th Grade 4
    D6 Who spent the most time taking care of you in the last three months? Both Parents 1
    D7 The next set of questions is about your physical health. During the last 3 months, did you have trouble seeing the chalkboard? YES 1
    D7a Do you wear glasses? NO 0
    D7b Have you seen an eye doctor about this? NO 1
    D8 During the last three months did you have trouble hearing? YES 1
    D8a Have you seen an ear doctor about this? NO 1
    D9 During the last three months did you have a toothache? YES 1
    D9a Have you seen a dentist about this? NO 1
    Social Phobia
    Question Answer Score
    Q1 In the last three months...Have you often felt very nervous or uncomfortable when you have been with a group of children or young people - say, like in the lunchroom at school or at a party? YES 1
    Q2 In the last three months ...Have you often felt very nervous when you've had to do things in front of people? YES 1
    Social Phobia Score (Criteria >= 2) 2
    Panic Disorder
    Question Answer Score
    Q3 For this question, I want to know if you have ever had a sudden attack of feeling very afraid. In the kind of attack I mean, someone becomes very afraid even though there is nothing around them to frighten them. Sometimes they feel they can't breathe ... sometimes their heart beats very fast. The attacks come on very suddenly and then go away, but they get afraid that the attacks might come back.In the last three months, have you had an attack when all of a sudden you felt you very afraid or strange? YES 1
    Q4 In the last three months ...Have you had a time when you suddenly felt that you were suffocating or couldn't breathe? YES 1
    Q5 Do you have asthma? NO 0
    Panic Disorder Score (Criteria >= 2) 2
    Generalized Anxiety
    Question Answer Score
    Q7 In the last three months ...Have you often worried a lot before you were going to play a sport or game or do some other activity? YES 1
    Q8 In the last three months ...Have you had a lot of headaches? YES 1
    Q9 In the last three months ... Have you had a lot of other aches and pains? YES 1
    Q10 Are you the kind of person who is often very tense, or who finds it very hard to relax? YES 1
    Generalized Anxiety Score (Criteria >= 3) 4
    Obsessive Compulsive Disorder
    Question Answer Score
    Q11 Some young people have times when one thought or idea comes into their mind over and over again. When people have these thoughts they usually get upset, because the thoughts are strange. No matter how hard they try, the thoughts keep coming back. Now I'm going to ask you if you have had thoughts like these in the last three months. Have you had to count things over and over again, or make yourself do things a certain number of times? YES 1
    Q12 In the last three months ... Was there a time when you washed your hands or body over and over again or changed your clothes many times each day because you thought they were dirty? YES 1
    Q13 In the last three months ... Have you often felt you should check on things over and over again? For example, checking that the front door is locked ... or the stove is turned off ... or that something else was done even though you knew it had been done. YES 1
    Q14 In the last three months ... Have you often worried over and over again that things you touch are dirty or have germs? YES 1
    Q15 In the last three months ...Have you had any other thoughts that kept coming back into your mind over and over again that you couldn't get rid of? YES 1
    Q16 In the last three months ... Have you done things like counting, checking or washing, over and over again because you like to do these things? YES 1
    Q17 In the last three months ... Have you done things like counting, checking or washing, over and over again, only because you've been told by someone else to make sure that you've done them right? NO 0
    Q18 In the last three months ... Have you wished you could stop yourself from doing things like counting, checking or washing over and over again? YES 0
    Q19 In the last three months ... Have you spent a lot of time each day doing things like counting, checking or washing over and over again ... say, for as long as an hour? YES 0
    Obsessive Compulsive Disorder Score (Criteria >= 4) 5
    Depression
    Question Answer Score
    Q20 In the last three months ... Has there been a time when nothing was fun for you and you just weren't interested in anything? YES 1
    Q21 In the last three months ... Has there been a time when you had less energy than you usually do? YES 1
    Q22 In the last three months ... Has there been a time when you felt you couldn't do anything well or that you weren't as good-looking or as smart as other people? YES 1
    Q23 In the last three months ... Has there been a time when you thought seriously about killing yourself? YES 1
    Q24 Have you tried to kill yourself in the last year? NO 0
    Q25 In the last three months ... Has there been a time when doing even little things made you feel really tired? YES 1
    Q26 In the last three months ... Has there been a time when you couldn't think as clearly or as fast as usual? YES 1
    Depression Score (Criteria >= 5) 6
    Alcohol
    Question Answer Score
    Q27 The next question is about your use of alcohol - beer, wine, wine coolers, or hard liquors like vodka, gin or whiskey. Each can or bottle of beer, glass of wine or wine cooler, shot of liquor, or mixed drink with liquor in it counts as one drink.In the last year, have you had six or more drinks? YES 1
    Q28 In the last year ...Did you get in trouble with the police when you were drunk or because you had been drinking? YES 1
    Q29 In the last year ...Did you get into arguments with your family or friends because of drinking? YES 1
    Q210 In the last year ...Did you miss school to go drinking or because you were hung over? YES 1
    Alcohol Score (Criteria >= 2) 4
    Marijuana
    Question Answer Score
    Q31 Have you used marijuana six or more times in the last year? YES 1
    Q32 In the last year ...Did you miss school to use marijuana or because you were too high on marijuana to go to school? YES 1
    Q33 In the last year ...Did you get into arguments with your family or friends because you were using marijuana? YES 1
    Marijuana Score (Criteria >= 2) 3
    Other Substances
    Question Answer Score
    Q34 Have you used any opiates to get high? This includes things like codeine, Demerol, morphine, percodan, methadone, Darvon, opium, Delaudid, Talwin and so on.In the last year have you used any of these to get high? NO 0
    Q35 In the last year ...Have you used any kind of hallucinogen? This includes LSD or "acid", mescaline, peyote, DMT, psilocybin and so on. NO 0
    Q36 In the last year ...Have you used stimulants or amphetamines ... like speed, diet pills, Benzedrine, methamphetamine or anything like that to get high? YES 1
    Q37 In the last year ...Have you used cocaine or "crack"? YES 1
    Q38 In the last year ... Have you used heroin? YES 1
    Q39 In the last year ...Have you used PCP or "Angel Dust"? YES 1
    Q310 In the last year ...Have you used Ecstasy or "E"? YES 1
    Q41 In the last year ...Have you used any inhalants ... like glue, cleaning fluid, gasoline or paint to get high? YES 1
    Other Substances Score (Criteria >= 1) 6
    Total DPS Symptom Score 25

    DPS Impairment Scale Reconstruction


    Question Answer Score
    Q42) How often did your parents feel worried or concerned about the way you were feeling or acting? A lot of the time 2
    Q42A) Were they worried or concerned because of:(Select ALL that apply, and then press the [ENTER] key to continue.)
    		You feeling anxious or worried
    		You feeling sad or depressed
    Q43) How often did your parents get annoyed or upset with you because of the way you were feeling or acting? A lot of the time 2
    Q43A) Were they annoyed or upset because of:
    		You feeling anxious or worried
    		You feeling sad or depressed
    Q44) How often were you not able to do things or go places with your family because of the way you felt or acted? A lot of the time 2
    Q44A) Were you not able to do things or go places because of:
    		You feeling anxious or worried
    		You feeling sad or depressed
    Q45) How often were you not able to do things or go places with other people your age because of the way you felt or acted? Some of the time 1
    Q45A) Were you not able to do things or go places because of:
    		You feeling anxious or worried
    		You feeling sad or depressed
    Q46) How often did the way you were feeling or acting make it difficult to do your schoolwork or cause problems with your grades? A lot of the time 2
    Q46A) Did you have problems with your schoolwork or grades because of:
    		You feeling anxious or worried
    		You feeling sad or depressed
    Q47) How often were your teachers annoyed or upset with you because of the way you were feeling or acting? A lot of the time 2
    Q47A) Were your teachers annoyed or upset because of:
    		You feeling anxious or worried
    		You feeling sad or depressed
    Q48) How often did the way you were feeling or acting make you feel bad or feel upset? A lot of the time 2
    Q48A) Did you feel bad or upset because of:
    		You feeling anxious or worried
    		You feeling sad or depressed
    Q49) Have you been to see someone at a hospital, or a clinic or at their office because of the way you were feeling or acting? NO 0
    Q50) I'd like to ask you about the interview you just completed. What did you think of it?(Press the [ENTER] key to continue.) Great!
    Total Impairment Score 13