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Message: <blockquote data-quote="midnightsun" data-source="post: 64657" data-attributes="member: 463">Done. Below are **(1) a clean SOAP note** and **(2) a concise psych evaluation impression paragraph**, both written the way they would actually appear in a chart. Language stays careful, dimensional, and non-diagnostic.---# 1) SOAP Note---## **S — Subjective**Patient reports a longstanding preference for solitude and limited desire for close interpersonal relationships. Describes social interaction as effortful and intrusive rather than rewarding. Denies subjective distress related to isolation and reports feeling most regulated when alone and engaged in internal or intellectual activities. Reports frequent mental preoccupation and introspection. Denies current hallucinations, delusions, mood instability, or anxiety symptoms. Denies suicidal or homicidal ideation. Notes occasional somatic awareness and reliance on solitary, self-soothing activities during periods of stress.---## **O — Objective**Appearance neat, appropriate, and somewhat withdrawn. Behavior calm and low-activation. Eye contact limited but appropriate. Speech normal in rate and volume, content abstract and internally focused. Affect constricted but congruent. Mood described as “neutral.” Thought processes linear but highly introspective. Thought content notable for individualized and abstract ideation; no overt delusions. Perceptual disturbances not observed. Cognition grossly intact. Insight fair. Judgment intact. Reality testing preserved at time of evaluation.---## **A — Assessment**Patient presents with a longstanding pattern of interpersonal detachment, restricted affect, and internally oriented cognition consistent with **schizoid-spectrum personality features**. Social withdrawal appears ego-syntonic and not associated with subjective distress. Cognitive style is abstract and ideational, with preserved but potentially stress-sensitive reality testing. No evidence at present of a primary psychotic disorder, mood disorder, or anxiety disorder. Current presentation does not meet criteria for a categorical personality disorder; formulation is best understood dimensionally, with prominent detachment and subthreshold psychoticism traits.---## **P — Plan*** No acute psychiatric intervention indicated.* Recommend supportive or psychodynamically informed psychotherapy if treatment is desired, with emphasis on containment and meaning-making rather than interpersonal activation.* Monitor over time for changes in reality testing, functional impairment, or emergence of maladaptive coping strategies (e.g., substance use).* Provide psychoeducation regarding personality structure and stress regulation.* Follow up as clinically indicated.---# 2) Psychological Evaluation – Impression ParagraphThe patient demonstrates a stable personality configuration characterized by marked interpersonal detachment, constricted affect, and predominantly internalized cognitive and emotional regulation. Social withdrawal is longstanding and ego-syntonic, with minimal reported distress. Thought processes are abstract and introspective, with individualized meaning-making and intact baseline reality testing, though potentially vulnerable under stress. Functioning appears contingent on environmental demands and intellectual capacity rather than relational support. Overall presentation is best conceptualized dimensionally as a detachment-dominant personality style with subthreshold psychoticism traits, rather than a categorical personality disorder.---If you want, I can:* Adjust this for **forensic, academic, or consult-liaison tone*** Add a **risk assessment subsection*** Or rewrite it to fit **specific EHR templates** (Epic, Cerner, etc.)Just say the word.</blockquote>

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