The "test" is self-directed/scored. You are deciding how to answer the questions, whether consciously or unconsciously, by how you feel at the moment. 100 is "average" and "normal" and all that kind of stuff so going from 111 to 93 is not necessarily all that different. If you saved both tests, I would look at what areas you did better in and think about what is different in your life in those areas over the last 4 years; what you have done/achieved that helped you feel better about yourself there. How you think/feel about the questions determine your score. I will always mark my weight and background the same so the test will always say I have problems there. But it is how I view my weight and background, not how the test scores the fact that I "have" a background there that matters. The test is to show you areas you might not have thought about working on or confirm vague feelings you might not have been able to put into words about what you might want to address with a therapist or through self-help.