Name: Gary Freedman
Dates of Evaluation: 2/24/2014
Date of Birth: 12/23/1953
Evaluator: David Angelich, Psy.D.
Reason for Referral:
Mr. Freedman sought a psychological evaluation in order to obtain more information about a diagnosis for himself. Mr. Freedman was evaluated in 1994 at George Washington University, but he did not receive a diagnosis from this assessment. He is currently seeking more specific information regarding a possible personality disorder diagnosis. Overall, this evaluation is thus requested to provide more information about Mr. Freedman’s emotional functioning to clarify treatment planning.
Millon Clinical Multiaxial Inventory – 3rd Edition (MCMI-III)
Minnesota Multiphasic Personality Inventory – 2nd Edition (MMPI-2)
Clinical Interview with Mr. Freedman
Consultation with Mr. Freedman’s psychiatrist, Dr. Shreiba
Relevant Background Information:
Family Background. Mr. Freedman is the older of two children. He has an older sister who is six years his senior. Mr. Freedman described a difficult and traumatic childhood. Mr. Freedman’s father was physically abusive toward him beginning at an early age. Mr. Freedman’s father was also physically abusive towards Mr. Freedman’s mother, attempting to strangle her to death at one time during Mr. Freedman’s childhood. Mr. Freedman described poor, abusive backgrounds of both of his parents as well. Mr. Freedman reported that he felt more intense anger at his mother for not protecting him from his father’s abuse, as opposed to conscious anger at his father.
Mr. Freedman’s parents have both been deceased since Mr. Freedman was in his 20’s. Mr. Freedman reported that he recalled feeling very little emotional responses when his mother passed away.
Relationship History. Mr. Freedman has been in one romantic relationship with a woman, which occurred when he was in his twenties. This relationship ended due to the woman’s insistence on marriage, which did not interest Mr. Freedman. This relationship lasted for one year. Mr. Freedman described little interest in pursuing a romantic relationship at the current time.
Educational/ Work History. Mr. Freedman is a Penn State graduate for his journalism degree, and he has Law Degree from Temple University. He received a Master of Laws from American University as well. During High School Mr. Freedman had few friends and ended one friendship due to the intense shame he felt about the abuse he suffered in his home growing up.
Mr. Freedman worked at the Franklin Institute beginning at the age of 16. He did editorial work and also managed a scientific publication at one time. Following his Master of Laws Degree, Mr. Freedman worked at a Law Firm doing legal research for approximately three and a half years. This job ended after Mr. Freedman described being overlooked for promotions despite earning high marks on his reviews. Mr. Freedman discussed feeling that he was being treated unfairly at the firm with fellow employees spreading rumors about him to damage his reputation. Mr. Freedman’s employment with this law firm ended, and Mr. Freedman did not return to work. He qualified for disability benefits at this time due to a mental health diagnosis.
Medical History. Mr. Freedman had scarlet fever as a young child. He also had an accident as a young child, where he fell with a curtain rod hitting him in his mouth resulting in significant bleeding.
Psychiatric History/ Previous Treatment. Mr. Freedman described wanting to see a psychiatrist since High School, but his parents would not permit this. In 1990, he began seeing a psychiatrist to work on family related problems. This treatment lasted for one year. In 1991, a psychologist treated Mr. Freedman for 20 weeks for hypnotherapy, but he was ultimately deemed not able to be hypnotized. In 1992, Mr. Freedman began treatments with psychiatric residents at George Washington University. Mr. Freedman reported that he did not want to take medication at this time. In 1999, Mr. Freedman began taking medication in the form anti-depressants. In 2001, he began taking Zyprexa which he stated was not helpful. Mr. Freedman has been taking Paxil for several years, which he states does stabilize his mood. He also takes Geodone, which he does not feel is helpful. Very recently, Mr. Freedman stopped taking Klonopin, which he reported has him feeling somewhat anxious.
Regarding substance abuse, Mr. Freedman drank a six-pack per day for two years from 1994 to 1996. He stopped on his own accord without specific treatment.
Mr. Freedman attempted suicide in 1974 by overdose. He was found unconscious while living with his mother during law school. He was not hospitalized at this time. Mr. Freedman has not been hospitalized for psychiatric problems.
Behavioral Observations/ Mental Status:
Mr. Freedman is a 60-year-old male of average stature who appears in good health. On the date of his evaluation he was dressed casually and appropriately. His thought processes were coherent, intact and goal directed. Mr. Freedman’s affect was somewhat flat. His mood appeared to be mildly depressed and anxious at times, but stable. He did not complain of depression. Mr. Freedman appeared somewhat anxious about the testing, but he gave good effort. Mr. Freedman was cooperative with voicing his thoughts through the interview and testing process. His judgment appeared poor to fair based on his interview process with this evaluator. Testing results are felt to represent an accurate estimate of his current emotional functioning.
Emotional/ Personality Functioning:
The MCMI-III and the MMPI-2 were given to assess Mr. Freedman’s personality and emotional functioning. The MCMI-III and MMPI-2 are structured personality measures that was administered to Mr. Freedman to determine the extent to which he may be experiencing psychiatric symptoms in addition to finding out more about his general personality make-up. Mr. Freedman’s profiles on the MCMI-III and MMPI-2 are consistent with his current presentation and congruent with his history. Test results are considered to represent a valid measure of his personality and current mental state.
The MCMI-III reports T Scores for the clinical measures and scales. A T score of 65 or above is considered statistically significant. On the Severe Clinical Syndromes Scales, Mr. Freedman obtained a T Score of 72 on the Delusional Disorder Scale. On the Severe Clinical Personality Patterns Scales, Mr. Freedman’s test profile revealed a T-Score of 67 on the Schizotypal Personality Pattern Scale. On the Clinical Personality Patterns Scales, he obtained a T Score of 105 in the Narcissistic Scale. Also in the Clinical Personality Patterns Scales, Mr. Freedman obtained a T- Scores of 65 and above (considered statistically significant) on the following scales: T Score of 85 in the Schizoid Scale, 78 on the Avoidant Scale and a T Score of 76 on the Depressive Scale.
Mr. Freedman’s MMPI-2 clinical scales showed elevations on 4 overall scales: the Psychopathic Deviate Scale #4 with a T Score of 69, the Paranoia Scale #6 with a T score of 83, the Social Introversion Scale #0 with a T Score of 70, and the Masculinity- Femininity Scale #5 with a T Score of 76. T scores are considered statistically significant if they are 65 or above. The two tiered personality code types are the most solidly supported by research. When a subject has several elevated clinical scales, the most salient features of each personality code type are used to describe the test subject. Mr. Freedman’s elevated Clinical Scales correspond primarily to the 4-6/ 6-4 personality code types.
Persons with the 4-6/ 6-4-code type are immature, narcissistic, and self-indulgent. They are passive-dependent individuals who make excessive demands on others for attention and sympathy, but they are resentful of even the mildest demands made on them by others. They do not get along well with others in social situations, and they are especially uncomfortable around members of the opposite sex. They are suspicious of the motivations of others and avoid deep emotional involvement. They generally have poor work histories and marital problems are quite common. They appear to be irritable, sullen, and argumentative. They seem to be especially resentful of authority and may derogate authority figures.
Individuals with the 4-6/ 6-4 code type tend to deny serious psychological problems. They rationalize and transfer blame to others, accepting little or no responsibility for their own behavior. They are somewhat grandiose and unrealistic in their self-appraisals. Because they deny serious emotional problems, they generally are not receptive to traditional professional counseling or therapy. In general, as the elevations of scales 4 and 6 increases and as scale 6 becomes higher than scale 4, a pre-psychotic or psychotic disorders becomes more likely. They present with vague emotional and physical complaints. They report feeling nervous and depressed, and they are indecisive and insecure.
Overall testing results support the diagnosis of a Delusional Disorder-persecutory type along Axis I. It is noted that Mr. Freedman was administered the Wisconsin Card Sorting Test at The George University Medical School in March 1996 and achieved a perfect score (6 errors). As noted in this previous 1996 evaluation, the reader is reminded that Mr. Freedman’s delusions are without prominent mood symptoms, auditory hallucinations or a formal thought disorder. Mr. Freedman also did not report symptoms of mania as demonstrated by his T score of 36 on Scale 9 (Mania). Mr. Freedman did earn a T score of 70 on the Social Introversion Scale, Scale 0. On another content measure of Social Introversion, the SOD Scale, Mr. Freedman earned a T Score of 81. Although diagnosed with Alcoholism in the past, Mr. Freedman did not report significant addiction difficulties in the present evaluation; he earned a T Score of 48 on the MAC-R Scale (Addiction Proneness). Mr. Freedman earned a T score of 43 on the Es content scale (Ego Strength).
Regarding Axis II, and personality disorders, Mr. Freedman has prominent features of several different personality disorders, as noted in his MCMI-III results as well as the MMPI-2 as noted above. It is felt that he can best be described as having a Personality Disorder, NOS with Prominent Narcissistic, Schizoid, and Avoidant Traits with Depressive Personality Features.
Continued medication management as well as long-term therapy is recommended for Mr. Freedman.
It was truly a pleasure working with Mr. Freedman to complete this evaluation. If you have any questions or need additional information, please do not hesitate to contact Dr. Angelich at (202) 494 6722.
David Angelich, Psy. D.
DC License Number: PSY1000493