[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-292792-105":59,"doc-detail-292792-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","elevated-rap-high-probability-results-on-an-adult-sassl-4-clinical-interpretation-overview","Elevated RAP/ High Probability Results on an Adult SASSl-4 - Clinical Interpretation Overview","","Interpretation of Elevated RAP and high probability results for an adult female on the Adult SASSl-4, based on the last 12 months. The profile is unusual: most scale scores fall within normal percentiles except a SYM elevation above the 85th percentile. Findings suggest acknowledgment of symptoms and consequences and possible association with heavy-using friends or family. Decision rules support a high probability of a substance use disorder, while SAT and OAT scores indicate awareness may vary.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/elevated-rap-high-probability-results-on-an-adult-sassl-4-clinical-interpretation-overview/292792/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/elevated-rap-high-probability-results-on-an-adult-sassl-4-clinical-interpretation-overview/292792.png","ImageObject",300,407,{"name":92,"@type":93},"Emma Wilson","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-17",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What makes the adult SASSl-4 profile unusual in this case?","Question",{"text":112,"@type":113},"All scale scores are within the norm except the SYM score, which is above the 85th percentile. The elevated probability results occur despite some scores being only above average, not above the 85th percentile.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What do the decision rules imply about substance use disorder probability?",{"text":117,"@type":113},"The client meets decision rules 5, 6, 9 and 10, meeting criteria for a high probability of a substance use disorder. Meeting more rules does not automatically indicate greater severity; DSM-5 criteria determine diagnosis and severity.",{"name":119,"@type":110,"acceptedAnswer":120},"How should an unexpected RAP score be handled?",{"text":121,"@type":113},"A RAP score of 2 or more needs exploration, preferably with the client. The items causing difficulty were: “I never have been picked on and I have never been sad,” and cultural and language context should be considered.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},292792,1792106134,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":19,"category_name":20,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24},3848291630094,"https://eur-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Elevated RAP/ High Probability Results on an Adult SASSl-4  \nThis profile on a 21-year-old female with the FVA and FVOD, based on the last  \n12 months, is interesting primarily because it is so unusual.  \nAs you look at the profile graph, all the scale scores are within the norm, i.e., between the 15th and 85th percentiles except for the SYM score which is above the 85th percentile. This tells you that she is acknowledging symptoms and consequences of her use and indicates she is associating with friends or family who are also heavy users. This is a bit of a contrast to her FVA and FVOD scores, both of which are above average but not above the 85th percentile.  \nThe SAT score of 5 is within the norm which is a positive-no denial or lack of awareness or insight is indicated. However, with the OAT score within the norm, it is a possibility that she does not identify with other substance users and those characteristics we associate with substance users such as impatience, self-pity, resentment, or impulsivity. If marijuana is her primary drug, she may not see it as a problem so the high probability of a substance use disorder may be an unexpected result for the client.  \nAnother positive is the DEF score, which is above average but not clinically significant since it is below the 85th percentile.  \nThe client meets decision rules 5, 6 and 9 and 10 thus meeting the criteria for a high probability of a substance use disorder. As a reminder, more rules that are met does not mean a more severe problem. As we often mention on the clinical helpline, the diagnosis and severity of a substance use disorder is based on the criteria in the DSM-5.  \nNote the Prescription Drug Scale score of 2. It does not meet the cut-off criteria for prescription drug abuse, but it is worth a look at those items she endorsed.  \nThe caller was puzzled by the RAP score of 2 and how it affected the result of the SASSI.  \nA RAP score of 2 or more always needs to be explored, preferably with the client. The two items which posed the problem were 'I never have been picked on and I have never been sad' .  \nCultural and language contexts need to be considered for possible reasons the client answered as she did. The possibility of her deliberately trying to 'skew' the questionnaire is low given the high probability result. More likely, the client answered accurately for her based on her life experience.  \nThe clinician can now safely accept the overall result as valid.  \nAs a reminder, the free clinical helpline, (800-726-0526) is available M-F, 12-5 pm (EST) for any questions you may have. We also offer a free Q&A zoom meeting once a month for an hour as well. Please check the blog notice for dates and time to register. And finally, if you have additional inquiries, please contact the Clinical Director, Kristin Kimmell, LCSW, LCAC at [kristin@sassi.com](kristin@sassi.com).  \n© 1990-2016 Miller Woods, LLC P a g e | 1  \n© 1990-2016 Miller Woods, LLC P a g e | 2","cbCaifTbU5vGH1r3","https://ap.wps.com/l/cbCaifTbU5vGH1r3","pdf",193041,"English","# Elevated RAP/High Probability Results Overview\n## Profile Unusual Pattern and Scale Score Meaning\n## Decision Rules and Substance Use Disorder Probability\n## RAP Score Review and Cultural Context Considerations","[{\"question\":\"What makes the adult SASSl-4 profile unusual in this case?\",\"answer\":\"All scale scores are within the norm except the SYM score, which is above the 85th percentile. The elevated probability results occur despite some scores being only above average, not above the 85th percentile.\"},{\"question\":\"What do the decision rules imply about substance use disorder probability?\",\"answer\":\"The client meets decision rules 5, 6, 9 and 10, meeting criteria for a high probability of a substance use disorder. Meeting more rules does not automatically indicate greater severity; DSM-5 criteria determine diagnosis and severity.\"},{\"question\":\"How should an unexpected RAP score be handled?\",\"answer\":\"A RAP score of 2 or more needs exploration, preferably with the client. The items causing difficulty were: “I never have been picked on and I have never been sad,” and cultural and language context should be considered.\"}]","Elevated RAP/ High Probability Results on an Adult SASSl-4 - Clinical Interpretation Overview | PDF",1789655736]