Adolescents frequently have elevations on Scale 4, and it will be their highest overall scale. A full one third of the clinical sample used in the development of the MMPI-A had elevations of 65 or more. These generally high scores most likely reflect their often turbulent attempts to form a sense of identity and achieve independence from their parents. Thus, the elevation might be part of a temporary phase of development rather than a permanent enduring trait. However, high or extremely high scores will still reflect significant levels of pathology. Such scores are associated with delinquents who commit antisocial acts (see A-ang/Anger and A-con/Conduct Problems scales), are in conflict with their fami1ies (see A-fam/Family Problems), school-related difficulties (see A-Sch/School Problems), and are involved with drugs and/or alcohol (see MAC-R, ACK/Alcohol Drug Acknowledgment , and PRO/Alcohol Proneness supplementary scales). Often they report little guilt for this acting out and appear impervious to punishment. Additional difficulties might include externalizing behavior problems (lying, cheating , stealing, temper outbursts, jealousy) and school dropout. Boys frequently report physical abuse and having run away arid girls similarly report physical abuse but also having been sexually abused. They are also likely to be sexually active. Often they are not particularly motivated to become involved in therapy. Because Scale 4 is quite heterogeneous with a correspondingly high number of descriptors, a formal scoring and inspection of the Harris-Lingoes scales can often be extremely useful in determining which of the scale descriptors is most appropriate.