SCL-90 Test Results: What Do Your Scores Actually Mean?

Introduction: Making Sense of Your Numbers

You've completed the SCL-90 assessment and now you're looking at your results—a collection of scores, percentiles, and perhaps color-coded indicators. What do these numbers actually mean for your mental health? How should you interpret them? And most importantly, what should you do next?

This comprehensive guide will walk you through every aspect of interpreting your SCL-90 results, from understanding the basic scoring system to knowing when scores warrant professional attention. Remember: these scores are tools for understanding, not final judgments about your mental health.

The SCL-90 Scoring System: An Overview

Raw Scores vs. Standardized Scores

When you complete the SCL-90, your responses are converted into scores through several steps:

Raw scores represent the sum of your ratings across the items in each dimension. Since you rate each item from 0 (not at all) to 4 (extremely), higher raw scores indicate more symptom severity.

Standardized scores (often called T-scores) convert your raw scores to a standardized scale, typically with a mean of 50 and a standard deviation of 10. This allows comparison with normative populations.

The Three Global Indices

Before diving into individual symptom dimensions, let's understand the three summary scores that provide an overall picture of psychological distress:

1. Global Severity Index (GSI)

What it measures: The GSI is the single best indicator of your current overall level of psychological distress. It combines information about both the number of symptoms you're experiencing and their intensity.

How it's calculated: GSI is computed by summing the ratings on all 90 items and dividing by 90 (the total number of items). This gives an average distress score across all symptom areas.

Interpretation ranges (approximate):

• GSI < 0.50: Minimal distress; within normal range
• GSI 0.50-1.00: Mild distress; some symptoms present
• GSI 1.00-1.50: Moderate distress; multiple symptoms at noticeable levels
• GSI 1.50-2.50: Marked distress; significant symptoms warranting professional evaluation
• GSI > 2.50: Severe distress; immediate professional consultation recommended

What your GSI score means:

Example 1: GSI of 0.35 You're reporting minimal psychological symptoms. This suggests overall good mental health, though it doesn't mean you never experience any difficulties. Continue monitoring your mental health and practicing good self-care.

Example 2: GSI of 1.20 You're experiencing moderate levels of distress. This level suggests meaningful symptoms that are impacting your quality of life. Consider consulting with a mental health professional to discuss your specific concerns.

Example 3: GSI of 1.85 You're reporting marked distress across multiple areas. This level strongly suggests that professional evaluation and support would be beneficial. Don't delay in reaching out to a qualified mental health provider.

2. Positive Symptom Total (PST)

What it measures: The PST counts how many of the 90 items you rated higher than 0 (not at all). It reflects the breadth of your symptoms rather than their intensity.

Interpretation:

• Low PST (0-30): Few symptoms endorsed; distress is focused in specific areas
• Moderate PST (31-60): Moderate number of symptoms across various domains
• High PST (61-90): Numerous symptoms across many areas; suggests widespread distress

What PST reveals:

A high PST with a moderate GSI might indicate many symptoms at low intensity (lots of things bothering you "a little bit"). Conversely, a low PST with a high GSI suggests intense symptoms in just a few areas (severe distress focused on specific problems).

Clinical significance:

• High PST + High GSI: Widespread, intense distress—comprehensive treatment approach likely needed
• High PST + Low GSI: Many symptoms at low levels—may benefit from stress management and coping skills
• Low PST + High GSI: Focused, intense symptoms—targeted treatment for specific issues
• Low PST + Low GSI: Minimal symptoms overall—good mental health baseline

3. Positive Symptom Distress Index (PSDI)

What it measures: The PSDI is the average intensity of symptoms for items you rated above 0. It's calculated by dividing your total score by the PST (number of symptoms endorsed).

Interpretation:

• Low PSDI (0-1.5): Symptoms present are relatively mild
• Moderate PSDI (1.5-2.5): Symptoms present are moderately intense
• High PSDI (2.5-4.0): Symptoms present are quite intense to extreme

What PSDI reveals:

The PSDI helps identify your response style and symptom intensity pattern:

• High PSDI: When you experience symptoms, you experience them intensely
• Low PSDI: Your symptoms, when present, tend to be milder
• Very high PSDI (>3.0): Possible over-reporting or cry for help; alternatively, genuinely extreme distress

Understanding the Nine Symptom Dimensions

Your results will include scores for each of the nine primary symptom dimensions. Each dimension represents a distinct cluster of psychological symptoms that can help identify specific areas of concern. For an in-depth exploration of how these dimensions were developed and what they measure, see our comprehensive article on the 9 symptom dimensions of SCL-90. Let's explore how to interpret each:

1. Somatization (SOM)

What it measures: Physical symptoms associated with psychological distress

Score interpretation:

• Low (<1.0): Few physical manifestations of distress
• Moderate (1.0-2.0): Some somatic symptoms present
• High (>2.0): Significant physical symptoms that may have psychological origins

What high scores suggest:

• Stress manifesting physically
• Possible psychosomatic conditions
• Need to rule out medical causes while addressing psychological factors
• May benefit from mind-body approaches (meditation, biofeedback, therapy)

Action steps for elevated scores:

• Schedule medical evaluation to rule out physical causes
• Discuss with a therapist who understands mind-body connections
• Learn stress management techniques
• Consider yoga, progressive muscle relaxation, or somatic therapy

2. Obsessive-Compulsive (O-C)

What it measures: Repetitive thoughts and behaviors that are unwanted and distressing

Score interpretation:

• Low (<1.0): Few obsessive or compulsive symptoms
• Moderate (1.0-2.0): Some persistent thoughts or checking behaviors
• High (>2.0): Significant obsessive thinking or compulsive actions

Important distinction: High scores indicate obsessive-compulsive symptoms but not necessarily Obsessive-Compulsive Disorder (OCD). Clinical OCD requires specific diagnostic criteria beyond this screening.

What high scores suggest:

• Difficulty letting go of worrying thoughts
• Excessive checking or repetitive behaviors
• Perfectionism or need for certainty
• May benefit from cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP)

3. Interpersonal Sensitivity (I-S)

What it measures: Feelings of inadequacy and discomfort in interpersonal situations

Score interpretation:

• Low (<1.0): Comfortable in social situations; secure sense of self
• Moderate (1.0-2.0): Some social discomfort or self-consciousness
• High (>2.0): Significant interpersonal difficulty and sensitivity to rejection

What high scores suggest:

• Social anxiety or avoidance
• Low self-esteem in social contexts
• Fear of judgment or criticism
• May benefit from social skills training, cognitive therapy, or group therapy

4. Depression (DEP)

What it measures: Symptoms of depressive disorders including low mood, anhedonia, and hopelessness

Score interpretation:

• Low (<1.0): Minimal depressive symptoms
• Moderate (1.0-2.0): Some depressive symptoms; mild depression possible
• High (>2.0): Significant depressive symptoms warranting professional evaluation

Critical threshold: If specific items about self-harm or suicidal thinking were rated highly, seek immediate professional help regardless of overall depression score.

What high scores suggest:

• Possible depressive disorder (Major Depression, Persistent Depressive Disorder)
• Need for evaluation regarding therapy and/or medication
• Assessment of suicide risk
• Potential benefit from cognitive-behavioral therapy, interpersonal therapy, or antidepressant medication

5. Anxiety (ANX)

What it measures: General signs of anxiety including tension, nervousness, and panic

Score interpretation:

• Low (<1.0): Minimal anxiety symptoms
• Moderate (1.0-2.0): Some anxiety; may be situational
• High (>2.0): Significant anxiety affecting daily functioning

What high scores suggest:

• Possible anxiety disorder (Generalized Anxiety Disorder, Panic Disorder)
• Chronic stress
• Need for anxiety management strategies
• May benefit from CBT, mindfulness practices, relaxation training, or medication

6. Hostility (HOS)

What it measures: Thoughts, feelings, and behaviors associated with anger

Score interpretation:

• Low (<1.0): Little anger or irritability
• Moderate (1.0-2.0): Some anger issues; may be context-dependent
• High (>2.0): Significant anger problems affecting relationships and functioning

What high scores suggest:

• Anger management needed
• Possible irritability due to other conditions (depression, anxiety, trauma)
• Relationship difficulties
• May benefit from anger management programs, DBT skills, or addressing underlying conditions

7. Phobic Anxiety (PHOB)

What it measures: Persistent, irrational fear of specific stimuli

Score interpretation:

• Low (<1.0): Minimal phobic responses
• Moderate (1.0-2.0): Some specific fears or avoidance
• High (>2.0): Significant phobic anxiety with avoidance behaviors

What high scores suggest:

• Specific phobia, social phobia, or agoraphobia
• Avoidance patterns limiting life activities
• May benefit from exposure therapy, CBT, or systematic desensitization

8. Paranoid Ideation (PAR)

What it measures: Suspicious thinking, fear of loss of autonomy, and paranoid thoughts

Score interpretation:

• Low (<1.0): Little suspicious or paranoid thinking
• Moderate (1.0-2.0): Some mistrust or suspicion
• High (>2.0): Significant paranoid thinking requiring evaluation

What high scores suggest:

• Paranoid personality features
• Possible delusional thinking (if very high)
• Trauma-related hypervigilance
• Social anxiety manifesting as suspicion
• Requires professional evaluation to determine nature and severity

9. Psychoticism (PSY)

What it measures: Social alienation, isolation, and schizoid lifestyle; in extreme cases, psychotic symptoms

Score interpretation:

• Low (<1.0): Good social connection and reality testing
• Moderate (1.0-2.0): Some social withdrawal or alienation
• High (>2.0): Significant isolation or unusual thinking patterns

Important note: Despite the name, high scores more commonly reflect social isolation and alienation rather than psychotic disorders. However, very high scores warrant professional evaluation.

What high scores suggest:

• Social withdrawal or isolation
• Schizoid personality features
• Possible prodromal symptoms (early warning signs of psychosis)
• Need for social skills training or therapy addressing isolation

Clinical Thresholds: When to Seek Help

Understanding T-Scores

Many SCL-90 reports convert raw scores to T-scores:

• T-score < 60: Within normal range
• T-score 60-63: Mild elevation; borderline clinical significance
• T-score 63-70: Moderate elevation; clinical attention suggested
• T-score > 70: Marked elevation; professional evaluation strongly recommended

Critical vs. Non-Critical Elevations

Non-urgent elevations (T-scores 60-70):

• Schedule appointment with mental health professional within 2-4 weeks
• Begin researching therapists or counseling services
• Implement self-care strategies while awaiting professional consultation
• Monitor symptoms for worsening

Urgent elevations (T-scores > 70):

• Seek professional evaluation within days, not weeks
• Contact your primary care physician for referral
• Reach out to mental health crisis services if needed
• Don't minimize the significance of these scores

Crisis indicators: Regardless of overall scores, if you endorsed certain critical items at high levels (thoughts of suicide, intent to harm others, severe psychotic symptoms), seek immediate help:

• Call 988 (Suicide & Crisis Lifeline) in the US
• Go to an emergency room
• Contact a crisis mental health service
• Tell someone you trust what you're experiencing

Screening Results vs. Clinical Diagnosis

The Critical Distinction

The SCL-90 is a screening tool, not a diagnostic instrument. This distinction is crucial:

Screening tools:

• Identify people who may have a condition
• Indicate areas warranting further evaluation
• Can be self-administered
• Provide probabilistic information (you might have this condition)
• Have sensitivity and specificity limits (some false positives and false negatives)

Diagnostic instruments:

• Definitively identify whether someone meets criteria for a specific disorder
• Require administration and interpretation by trained professionals
• Use more comprehensive assessment processes
• Result in formal diagnoses

What Your SCL-90 Results Can and Cannot Tell You

What they CAN tell you:

• Which symptom areas you're experiencing
• The overall level of your psychological distress
• Whether your symptom pattern suggests possible mental health conditions
• Whether professional evaluation is recommended
• How your symptoms compare to normative populations

What they CANNOT tell you:

• A definitive diagnosis (e.g., "You have Major Depressive Disorder")
• What caused your symptoms
• What specific treatment you need
• Your prognosis or outcome
• Whether you have or don't have a specific DSM-5 disorder

The Next Steps After Screening

If your results suggest possible mental health concerns:

1. Schedule an evaluation with a qualified professional:

   • Psychologist
   • Psychiatrist
   • Licensed clinical social worker
   • Licensed professional counselor

2. Bring your SCL-90 results to the appointment:

   • They provide valuable baseline information
   • Help the professional understand your self-perception of symptoms
   • Can guide the clinical interview

3. Expect a comprehensive diagnostic process:

   • Detailed clinical interview
   • Possibly additional standardized assessments
   • Review of personal and family history
   • Discussion of symptoms in context of your life circumstances

4. Diagnosis leads to treatment planning:

   • Specific diagnoses guide evidence-based treatment selection
   • Treatment plans are individualized based on your unique presentation
   • May include therapy, medication, lifestyle changes, or combination approaches

Understanding Normative Comparisons

Many SCL-90 reports show how your scores compare to "normal" populations. Understanding these comparisons requires nuance:

Normative Groups

Your scores might be compared to:

• General population: Community samples of adults
• Psychiatric outpatients: People seeking mental health treatment
• Age-matched groups: People in your age bracket
• Gender-matched groups: Comparison with your same gender

Percentile Interpretation

If your results show percentiles:

• 50th percentile: Average (right in the middle)
• 75th percentile: Higher than 75% of the comparison group
• 90th percentile: Higher than 90% of the comparison group
• 95th percentile and above: Significantly elevated

Important context: Being at the 95th percentile compared to the general population means you're reporting more symptoms than 95% of people in the community—this warrants attention. However, being at the 50th percentile compared to psychiatric outpatients means your symptoms are typical for people seeking mental health treatment—still significant, but contextually different.

Putting It All Together: Pattern Analysis

Don't just focus on individual scores—look at patterns:

Elevated Across All Dimensions

Pattern: High GSI, high scores across most or all dimensions

Interpretation:

• Generalized psychological distress
• Possible mood disorder affecting multiple domains
• Chronic stress overwhelming multiple systems
• Possible complex trauma

Next steps:

• Comprehensive mental health evaluation
• Consider whether recent life stressors explain the broad pattern
• Evaluation for depression, anxiety disorders, or PTSD

Specific Elevation Pattern

Pattern: Most dimensions normal, but 1-2 are markedly elevated

Interpretation:

• Focused problem area
• Specific disorder likely (e.g., high DEP only might suggest pure depression)
• Targeted issue (e.g., only HOS elevated might indicate anger problem)

Next steps:

• Focus on the specific elevated area(s)
• Seek specialist in that problem area if possible
• Consider targeted treatment approaches

Physical/Psychological Split

Pattern: High SOM with elevated DEP or ANX; other dimensions moderate

Interpretation:

• Mind-body connection prominent
• Stress or emotional distress manifesting physically
• Possible medically unexplained symptoms

Next steps:

• Rule out medical causes first
• Seek providers who understand psychosomatic medicine
• Consider integrated treatment approaches

Common Misinterpretations to Avoid

"Low scores mean I don't need to do anything"

Even in the normal range, scores can provide valuable information about areas to monitor or strengthen through preventive mental health practices.

"High scores mean I'm 'crazy' or 'broken'"

High scores indicate symptoms, not character defects. They're indicators of distress that can be addressed with appropriate support.

"I can diagnose myself based on these scores"

Resist this temptation. Self-diagnosis based on screening tools often leads to inaccurate conclusions and unhelpful anxiety.

"These scores will determine my treatment"

Scores inform treatment but don't dictate it. Your full clinical picture, including history, current circumstances, and treatment goals, guides care planning.

Your Action Plan Based on Results

If Your Scores Are Within Normal Range

• Celebrate good mental health
• Continue or establish preventive practices (exercise, sleep, social connection, stress management)
• Remain aware of your baseline for future comparison
• Consider retaking the assessment periodically to track changes—learn more about when to retest for effective monitoring

If Your Scores Show Mild to Moderate Elevation

• Schedule an appointment with a mental health professional for evaluation
• Begin implementing self-care strategies (can start immediately)
• Research evidence-based treatments for your specific symptom pattern
• Tell a trusted friend or family member about your results for support
• Don't catastrophize, but do take the results seriously
• Consider creating a mental health action plan to address your specific symptom patterns
• If you're in therapy, explore our guide on SCL-90 and therapy guidance to understand how your scores can inform treatment

If Your Scores Show Marked Elevation or Crisis Indicators

• Seek professional help immediately or within days
• Don't delay due to stigma, cost concerns, or minimization
• Use employee assistance programs, community mental health centers, or sliding-scale clinics if needed
• Prioritize this above other commitments—mental health is essential health
• If in crisis, use crisis resources immediately (don't wait for an appointment)

Conclusion

Your SCL-90 results are a snapshot of your current psychological state—valuable information that can guide your mental health journey. The numbers themselves are neither good nor bad; they're simply data that, when properly interpreted, can help you understand yourself better and make informed decisions about seeking support.

Remember that elevated scores indicate areas where you're struggling—they don't define who you are. With appropriate support, virtually all of the conditions screened by the SCL-90 are treatable. Taking the assessment and learning about your results are important first steps toward improved wellbeing.

Use your results as a tool for empowerment, not for self-judgment. They provide a roadmap for where to focus your mental health efforts and can facilitate more productive conversations with healthcare providers. Whatever your scores reveal, remember that seeking to understand and improve your mental health is a sign of strength and self-awareness.