ptsd Need help understanding PTSD C&P results and MMPI

[Aaliaha]

I had my PTSD C&P on Aug 29th.  Ebenefits moved from Gathering of Evidence to Prep for Decision on Aug 31st.  I was diagnosed with PTSD/MDD April 2016 when I was admitted into VA Psych Ward for 2 weeks.  Afterwards I was an inpatient in the PTSD program for 50 days.


C&P Results: All PTSD symptoms was checked off: Anxiety, depression, ect..
Criterian B:  All checked for Instusion symptoms
Criterian C: Persistent avoidance all checked off
Criterian D: Negative alterations in cognitions and mood ect... all checked off
Critierian E. Alerternation in arousal/ hypervigilance ect.. all checked off

I meet everything with the PTSD criteria with sucuide ideation

(X) Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgement, thinking and/or mood

Remarks, (including testing results)  The MMPI test was almost 400 T/F questions!!!

He wrote: With an Associates Degree she last worked full time in the Navy due to anxiety in 2002.

Her intellect is within the High Average range based on Vocabulary SS 12 on the WAIS III.  Her valid MMPI shows Depression at 106 T-scores with Schizoprenia, Psychasthenia, and Social Introversion 75-85 T-scores and PTSD PK97 T-Scores. Severe PTSD.  I also applied to Individual Unemployability

I'm trying to understand this... Is the Schizoprenia a diagnosis? Cause I'm really freaked out over it. Is schizoprenia normal for a PTSD diagnosis? Is this something that would be rated differently or will it go under the PTSD rating?  I've been trying to google the MMPI and C&P exams but cant find much on the scoring part.

Plus any opinion on what you think my rating can be will be helpful as well. 

Thanks :-)

Edited September 5, 2016 by Aaliaha

[GuaymasJim]

No to your question:  Is the Schizophrenia a diagnosis? It is Scale 8 on the MMPI2.  Depression is Scale 2.  Neither one is a diagnosis. Your two highest standard deviations from normal (what ever the hell that is) give you a 8/2 Profile .  Either way, your MMPI-2 RF results are the most common for veterans with PTSD.  The MMPI-2 RF and PK Scale for PTSD are relatively new and there is some controversy attached to them. Your scores do indicate Severe PTSD (according to the people who accept the MMPI-2 RF and PK Scale for PTSD as valid assessors of PTSD-not everyone does including me).  Do not freak out! The names of the 8 Scales have nothing to do with diagnosis! It was only one of the components of your C&P.

I have uploaded a fairly good (but nerdy) explanation of the MMPI-2. Google " MMPI-2 RF PTSD 8/2 Profile" without the quotes. You will get a ton of results.

"(X) Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgement, thinking and/or mood"

That is the second highest DBQ severity level right below Total.  I don't see it matching the test results, but there is now way of telling how a rater will look at it.

I hope this helps.

MMPI2.pdf

[Aaliaha]

Thank you!  It was very helpful! :-)

[Gastone]

Any chance you post a redacted copy of your PTSD C & P DBQ?

Semper Fi

[Aaliaha]

13 hours ago, Gastone said:

Any chance you post a redacted copy of your PTSD C & P DBQ?

Semper Fi

1. Diagnostic Summary

---------------------

Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria

based on today's evaluation?

[X] Yes [ ] No

ICD code: DSM-5 309.81

 

2. Current Diagnoses

--------------------

a. Mental Disorder Diagnosis #1: Posttraumatic Stress Disorder

ICD code: DSM-5 309.81

Comments, if any:

b. Medical diagnoses relevant to the understanding or management of the

Mental Health Disorder (to include TBI): None

ICD code: None

Comments, if any: Severe PTSD.

 

3. Differentiation of symptoms

------------------------------

a. Does the Veteran have more than one mental disorder diagnosed?

[ ] Yes [X] No

c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?

[ ] Yes [X] No [ ] Not shown in records reviewed

4. Occupational and social impairment

-------------------------------------

a. Which of the following best summarizes the Veteran's level of

occupational

and social impairment with regards to all mental diagnoses? (Check only

one)

[X] Occupational and social impairment with deficiencies in most areas,

such as work, school, family relations, judgment, thinking and/or

mood

b. For the indicated level of occupational and social impairment, is it

possible to differentiate what portion of the occupational and social

impairment indicated above is caused by each mental disorder?

[ ] Yes [ ] No [X] No other mental disorder has been diagnosed

c. If a diagnosis of TBI exists, is it possible to differentiate what

portion

of the occupational and social impairment indicated above is caused by

the

TBI?

[ ] Yes [ ] No [X] No diagnosis of TBI

 

SECTION II:

-----------

Clinical Findings:

------------------

1. Evidence Review

------------------

Evidence reviewed (check all that apply):

[X] VA e-folder (VBMS or Virtual VA)

[X] CPRS

Evidence Comments:

Veteran is treated at the local VA for PTSD/MDD with Hydroxyzene and

Elavil.

 

2. History

----------

a. Relevant Social/Marital/Family history (pre-military, military, and

post-military):

This 36 year old female is single,never married. She is difficult to interview because of her anxiety and

poor social skills but is sincere. She reports no real leisure

activities. She say her children are doing well. She has no current

boyfriend and is vague about her social adjustment. Her two children

are from 2 year relationships and she is unclear about the reason the

relationships did not last

b. Relevant Occupational and Educational history (pre-military, military,

and

post-military):

With an Associate Degree she last worked full time in the Navy due to

her anxiety. She is in the Work Therapy program at the local VA. In

the Navy 4 years and the Rank E5 Second Class Petty Officer 

 

c. Relevant Mental Health history, to include prescribed medications and

family mental health (pre-military, military, and post-military):

She reports a good childhood,good parents and no

family history of mental illness,crime or substance abuse. She has

been

Psychiatrically Hospitalized twice last time June/July 2016 at the

local VA where she is now treated. She cannot see the benefit of the

treatment. Current reported symptoms include nightmares,intrusive

thoughts,anxiety,depression,headaches,sees shadows,social

isolation,aversion to crowds,startle,suicidal ideation without

intent,crying spells.

d. Relevant Legal and Behavioral history (pre-military, military, and

post-military):

None

e. Relevant Substance abuse history (pre-military, military, and

post-military):

None

f. Other, if any:

No response provided.

 

3. Stressors

------------

Describe one or more specific stressor event(s) the Veteran considers

traumatic (may be pre-military, military, or post-military):

a. Stressor #1:

Does this stressor meet Criterion A (i.e., is it adequate to support

the diagnosis of PTSD)?

[X] Yes [ ] No

Is the stressor related to the Veteran's fear of hostile military

or

terrorist activity?

[X] Yes [ ] No

Is the stressor related to personal assault, e.g. military sexual

trauma?

[ ] Yes [X] No

4. PTSD Diagnostic Criteria

---------------------------

Please check criteria used for establishing the current PTSD diagnosis. Do

NOT mark symptoms below that are clearly not attributable to the Criterion A

stressor/PTSD. Instead, overlapping symptoms clearly attributable to other

things should be noted under #7 - Other symptoms. The diagnostic criteria

for PTSD, referred to as Criterion A-H, are from the Diagnostic and

Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Criterion A: Exposure to actual or threatened a) death, b) serious

injury,

c) sexual violence, in one or more of the following ways:

[X] Learning that the traumatic event(s) occurred to a close

family member or close friend; cases of actual or

threatened death must have been violent or accidental;

or,

experiencing repeated or extreme exposure to aversive

details of the traumatic events(s) (e.g., first

responders collecting human remains; police officers repeatedly exposed to details of child abuse); 

this does not apply to exposure through electronic media, television, movies, or

pictures, unless this exposure is work related.

 

Criterion B: Presence of (one or more) of the following intrusion symptoms

associated with the traumatic event(s), beginning after the

traumatic event(s) occurred:

[X] Recurrent, involuntary, and intrusive distressing

memories

of the traumatic event(s).

[X] Recurrent distressing dreams in which the content and/or

affect of the dream are related to the traumatic

event(s).

[X] Intense or prolonged psychological distress at exposure

to

internal or external cues that symbolize or resemble an

aspect of the traumatic event(s).

[X] Marked physiological reactions to internal or external

cues that symbolize or resemble an aspect of the

traumatic

event(s).

Criterion C: Persistent avoidance of stimuli associated with the

traumatic

event(s), beginning after the traumatic events(s) occurred,

as evidenced by one or both of the following:

[X] Avoidance of or efforts to avoid distressing memories,

thoughts, or feelings about or closely associated with

the

traumatic event(s).

[X] Avoidance of or efforts to avoid external reminders

(people, places, conversations, activities, objects,

situations) that arouse distressing memories, thoughts,

or

feelings about or closely associated with the traumatic

event(s).

Criterion D: Negative alterations in cognitions and mood associated with

the traumatic event(s), beginning or worsening after the

traumatic event(s) occurred, as evidenced by two (or more)

of

the following:

[X] Persistent negative emotional state (e.g., fear, horror,

anger, guilt, or shame).

[X] Markedly diminished interest or participation in

significant activities.

[X] Feelings of detachment or estrangement from others.

[X] Persistent inability to experience positive emotions

(e.g., inability to experience happiness, satisfaction,

or

loving feelings.)

Criterion E: Marked alterations in arousal and reactivity associated with

the traumatic event(s), beginning or worsening after the

traumatic event(s) occurred, as evidenced by two (or more)

of

the following:

[X] Hypervigilance.

[X] Exaggerated startle response.

[X] Problems with concentration.

[X] Sleep disturbance (e.g., difficulty falling or staying

asleep or restless sleep).

Criterion F:

[X] Duration of the disturbance (Criteria B, C, D, and E) is

more than 1 month.

Criterion G:

[X] The disturbance causes clinically significant distress or

impairment in social, occupational, or other important

areas of functioning.

Criterion H:

[X] The disturbance is not attributable to the physiological

effects of a substance (e.g., medication, alcohol) or

another medical condition.

Criterion I: Which stressor(s) contributed to the Veteran's PTSD

diagnosis?:

[X] Stressor #1

5. Symptoms

-----------

For VA rating purposes, check all symptoms that actively apply to the

Veteran's diagnoses:

[X] Depressed mood

[X] Anxiety

[X] Suspiciousness

[X] Panic attacks that occur weekly or less often

[X] Chronic sleep impairment

[X] Flattened affect

[X] Disturbances of motivation and mood

[X] Difficulty in establishing and maintaining effective work and social

relationships

[X] Difficulty in adapting to stressful circumstances, including work or

a

Work like setting

[X] Suicidal ideation

6. Behavioral Observations

--------------------------

Flat affect,withdrawn,reserved,depressed,intact,oriented.

7. Other symptoms

-----------------

Does the Veteran have any other symptoms attributable to PTSD (and other

mental disorders) that are not listed above?

[X] Yes [ ] No

If yes, describe:

Suicidal ideation without intent.

8. Competency

-------------

Is the Veteran capable of managing his or her financial affairs?

[X] Yes [ ] No

9. Remarks, (including any testing results) if any

--------------------------------------------------

Her intellect is within the High Average range based on Vocabulary SS 13

on the WAIS III. Her valid MMPI shows Depression at 106 T-Scores with

Schizophrenia,Psychasthenia and Social Introversion 75-85 T-Scores and

PTSD PK 97 T-Scores. Severe PTSD.

[Gastone]

That's a  70% PTSD SC DBQ with "Inferred IU," at the minimum. Good possibility of 100%, depending on the Rater.

Do you have any other non MH SC's, presently? Your head's definitely Fracked Up, but you don't appear to meet the VA Medically "Housebound" requirements. Never the less, keep SMC S (1) in mind, for future possible Secondary SC's.

If you haven't yet, give VA PTSD Group Therapy a try, doesn't cure it but definitely helps. Just something about talking to other Vet's with your same problem.

Semper Fi

[ArNG11]

Agree with Gastone on his analysis.