INTERNATIONAL MENTAL HEALTH NETWORK, LTD.
P.O. Box 578
Poway, CA 92074-0578
Phone: (858) 486-9745
Fax: (858) 486-9760
E-mail: nac01@juno.com
A package of 10 test booklets and 50 answer sheets
available for $25 from IMH-Network: (858) 486-9745
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S A M P L E P R O F I L E
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International Mental Health Network, Ltd.
TRAUMA SYMPTOM INVENTORY (TSI)
by
John Briere, PhD,
and PAR Staff
Client Information
Client Name : Bob Mason Age : 45
ID Number : 12345 Sex : Male
Race : Caucasian Test Date : 10/08/96
Prepared for : IMH-NETWORK, LTD.
Total Missing Responses: 0
--------------------------------------------
This report is confidential and is intended for use by qualified
professionals only. This report should not be released to the
individual being assessed.
Portions of this report examine domains of trauma that may
suggest the need for direct and expeditious intervention. The
professional using this report should examine the results
at her or his earliest convenience and, in conjunction with
other sources of information about the client provide timely
follow-up, treatment, or referral.
Trauma Symptom Inventory Scoring Program Version 1.0
Copyright (C) 1995
by Psychological Assessment Resources, Inc.
All rights are reserved.
_______________________________________________________________________________
Page 2
TSI Critical Items
Item Score
-------------------------------------------------------------------
19 3 Thoughts or fantasies about hurting someone
25 3 Threatening or attempting suicide
28 1 Getting into trouble because of sex
30 2 Wishing you were dead
40 1 Using drugs other than marijuana
48 1 Intentionally hurting yourself even though you
were not trying to commit suicide
50 1 Sexual fantasies about being dominated or overpowered
58 2 Getting into trouble because of your drinking
65 1 Hearing someone talk to you who was not really there
90 3 Feeling like life was not worth living
92 3 Seeing people from the spirit world
99 1 Thinking that someone was reading your mind
Warning, the following critical items with potentially
psychotic content have been endorsed.
* Hearing someone talk to you who was not really there
* Seeing people from the spirit world
* Thinking that someone was reading your mind
It is suggested that the respondent be interviewed regarding
the meaning of these endorsements. If it is possible that
the respondent is psychotic, consider further pyschological
testing or mental status evaluation. TSI protocols completed
by individuals with psychotic symptoms may require special
interpretation or may be invalid. Please see the TSI
Professional Manual.
? denotes skipped items
* denotes an invalid score due to missing responses
^ denotes a validity scale exceeding the cut-off score
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Page 3
TSI Validity and Clinical Scales
Scale Raw Score T Score
-------------------------------------------------------------------
AR Atypical Response 18 100^
RL Response Level 0 41
INC Inconsistent Response 11 80^
AA Anxious Arousal 11 58
D Depression 17 71
AI Anger/Irritability 17 65
IE Intrusive Experiences 14 69
DA Defensive Avoidance 13 62
DIS Dissociation 20 82
SC Sexual Concerns 19 78
DSB Dysfunctional Sexual Behavior 20 92
ISR Impaired Self-Reference 14 66
TRB Tension Reduction Behavior 16 91
TSI Summary Scales
Scale Raw Score T Score
-------------------------------------------------------------------
TR Trauma 61 71
SLF Self 86 81
DYS Dysphoria 45 67
? denotes skipped items
* denotes an invalid score due to missing responses
^ denotes a validity scale exceeding the cut-off score
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Page 4
TRAUMA SYMPTOM INVENTORY PROFILE
Name: Bob Mason Test Date: 10/08/96 Age: 45 Gender: Male
+-----------+--------------------------------+------------+
>=100 | X | | | >=100
| | | |
96 | | | | 96
| | | |
92 | | X X | | 92
|----+ | | |
88 | | | | | 88
| | | | |
84 | | | | | 84
| | | X | X |
80 | | X | | | 80
| | | X | |
76 | | +----+ | | 76
| |_| | | |
72 | | X | X | 72
| | X | |
68 | | | X | 68
| | X X | |
64 +-----------+--------------------------------+------------+ 64
| | X | |
60 | | | | 60
| | X | |
56 | | | | 56
| | | |
52 | | | | 52
+-----------+--------------------------------+------------+
48 | | | | 48
| | | |
44 | | | | 44
| X | | |
40 | | | | 40
| | | |
36 | | | | 36
<=35 +-----------+--------------------------------+------------+ <=35
A R I A D B OB BI D D S D I T T S D
T L N A I E A I C S S R R L Y
R C S B R B F S
T Score: 100 41 80 58 71 65 69 62 82 78 92 66 91 71 81 67
Raw: 18 0 11 11 17 17 14 13 20 19 20 14 16 61 86 45
IMH-Network, Ltd. Office: (619) 486-9745 Fax: (619) 486-9760