ID: Gender: F Date Filled: Clinician: Informant: Society: Name: - Age: 15 Birth Date: Agency: Relationship: Verified: 100 90 80 70 64 60 55 55 50 Sluggish Cognitive Tempo Obsessive-Compulsive Problems Stress Problems Raw (Sum) 1 2 9 T Score 55 55 64 Percentile 69 69 92 0 3.Argues 0 13.Confused 1 9.MindOff 80.Stares 85.StrangeIdeas 1 47.Nightmares 102.LacksEnergy 112.Worries 1 50.Fearful 52.Guilty B = Borderline clinical 69.Secretive 0 31.FearDoBad 1 8.Concentrate range; C = Clinical range; 87.MoodChang 0 32.Perfect 1 9.MindOff Broken Lines = Borderline 1 103.Sad 0 52.Guilty 0 11.Dependent clinical range 111.Withdrawn 0 66.RepeatsActs 0 31.FearDoBad 0 0 34.OutToGet Printed by: LOCAL\alma 0 17.Daydreams 84.StrangeBehav 2 45.Nervous
ID: Gender: F Date Filled: Clinician: Informant: Society: Name: - Age: 15 Birth Date: Agency: Relationship: Verified: 100 90 80 70 64 60 55 55 50 Raw (Sum) T Score Percentile Sluggish Cognitive Tempo 1 55 69 0 13.Confused Obsessive-Compulsive Problems 2 55 69 1 9.MindOff 0 3.Argues Stress Problems 9 64 92 B = Borderline clinical range; C = Clinical range; Broken Lines = Borderline clinical range 0 17.Daydreams 80.Stares 102.LacksEnergy 0 31.FearDoBad 0 32.Perfect 0 52.Guilty 0 66.RepeatsActs 0 84.StrangeBehav 85.StrangeIdeas 112.Worries 1 8.Concentrate 1 9.MindOff 0 11.Dependent 0 31.FearDoBad 0 34.OutToGet 2 45.Nervous 1 47.Nightmares 1 50.Fearful 52.Guilty 69.Secretive 87.MoodChang 1 103.Sad 111.Withdrawn Printed by: LOCAL\alma
CBCL-scoring-profile-with-narrative.docx