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Case Reports

Submitted by

Zunaira Mehmood

Submitted to

Dr. Afifa Anjum

Roll No. 48

MSc IV (Replica) Session: 2020-

INSTITUTE OF APPLIED PSYCHOLOGY,UNIVERSITY OF THE PUNJAB,

LAHOR

Case Report 1

Mental Health

Bio Data (^) K.A

Age 24 Gender Female Education Graduation Marital status Unmarried No. of siblings^5 Birth order 3 Fathers name A.A Mothers name Z.A Religion S.A Date of referral Islam

Reason for referral

The client was self referred

Presenting complaint:

Sr. NO Complaint Duration

1. I feel difficulty in time management. 6 month
2. I face difficulty in mange anger. 6 month
3. I face difficult to manage stress. 6 month
4. I am emotionally weak. 4 month

Medical history

The client is very energetic. The participant takes good care of herself and healthy.

Educational history

The client reported that she got her religious education from her aunt at the age of 4, and she started her education at the age of 3 years. She reported that she always a brilliant student. She reported that she still gets a position in the top ten. Her teacher was always satisfied with her performance. She still remembers when she was pre-nursery, and she got the first position her principal raised him in front of the audience to appreciate her. She got A+ in metric and intermediate. She tries to get admission in Medical, but she did not fall in that category and her aggregate just 4 percent below. In university, her CGPA falls in 3.3 range.

Social history

The client reported that she was friendly. She still has her school friends and has an outstanding interaction with them. Her interaction with her university friends is amiable. She can share anything with her three friends. Her friend is all are trustworthy. If the participant wants to share anything with any friend, they always support her to make a decision. Client like to go to a family function. In this week participant attend her friend wedding where her school friends were also there.

Personal life goals

The client reported that she wants to be a great human being. She likes the attitude of, Edhi. Late Ms Edhi was her inspiration.

Current life setting The client reported that she is currently in the final semester of her graduation. The participant is busy with assignments, report submission, vivas, and pending exams as this is the participant's final year, so she also busy with thesis synopsis submission. The client is introvert and participates in every gathering. Psychological Assessment The psychological assessment consisted of:

• Informal assessment
• Formal assessment

Informal Assessment Informal assessment consisted of:

• Mental State Examination Psychological assessment: Behavioral observation: General Appearance and Behavior

The client was comfortable and she did not shay to share her information The test was administrated face to face and language was Urdu .Time test taken by 30 mints. She was maintaining good eye contact. Her overall appearance was good. She was no tensed. She was a little bit nervous. Client was very cooperative.

Speech The client voice moderate during the whole session .Her speech was Understandable. She was curious about the interview. The client speaks Urdu and English. She answered all the questions asked from her. She did not show any kind of disorganized behavior.

Memory The client memory was pretty good. She was able to recall things easily. Recent memory The client resent memory was really good, she could easily recall her recent memory. Remote memory

The client remote memory was good too. She could easily recall her remote memory. There was no difficult for her to recall things.

Immediate memory The client was able to recall the set of words which was taught her earlier. Her immediate memory was too good.

Judgment and Insight The client had well developed insight and she had good judgment pertaining to the questions being asked.

Expressive and Receptive language She was expressive and communicated with the trainee counselor easily. She gave appropriate and logical responses and she reported that she doesn't like to talk to opposite gender and got nervous when talking to strangers.

Symptoms Rating

The client‘s and the informant‘s ratings of the symptoms from 0 – 10 in order of the Severity where 0 means very low and 10 means severity

Symptoms Client rating

Time issue 6 Fatigued 6 Anger issue 5 Stress 3 Emotionally weak 6

These symptoms ratings showed the mean score of client show that the client has the problem of Anger and inferiority complexion.

Formal Assessment Formal Assessment comprised of Rotter Incomplete Sentence Blank and Depression, interpersonal and self image test. Formal psychological assessment Rotter Incomplete Sentence Blank (RISB) RISB is a standardized procedure that provides a single score determining whether the person is adjust or maladjustment also provide the interpretation of one‘s general, social and familial. Rotter incomplete sentence blank is knew as RISB is a projective psychological test that

Quantitative Assessment

Response Abbreviations Corresponding standard score

Obtained score

Conflict 3 C3 3 6x3= Conflict 2 C2 3 5x3= Conflict 1 C1 6 4x6= Neutral N 12 3x12= Positive 3 P3 2 0x2= Positive 2 P2 8 1x8= Positive 1 P1 6 2x6= Ground total = 106

Conflict Response Positive Response Neutral Response Omitted Response 12 16 12 0

Percentage of

conflict response

Percentage of

positive response

Percentage of

neutral response

Percentage of

omitted response 30% 40% 30% 0%

Qualitative Assessment

The subject had scored 106 which is less than cut off score and it showed that subject is adjusted frame of mind.

Familial Attitude

The subject‘s completions provide a picture that she had strong affections with her father and she had better relationship with him.. And also, she considers her mother is blessing which shows that she was entirely dependent on her father according to relevant items (item number 35 and 11). She liked to go to home as the feel happy which shows that she had a positive attitude towards family and family members (item number 4). Item 26 shows that subject had a negative posture towards marriage as for marriage is a commitment Social and Sexual Attitude

The subject had neutral views regarding people. She had a good image for men as she said in item number 7 that some boys are strong. (Item number 34) Represents the wish that is nice. The subject had trustful picture for people as shewrote in item 10 as well as in item 19. She also had a good picture about women. General attitude

She said that in item no 38 dancing is good. In the school she was a bright student.

discrepancy between ratings of ―How I am‖ and ―How I would like to be ‖ .The SIP can be used in both an educational context by Teachers, Specialist support services and Educational Psychologists, and in health service environment by Psychologists, Pediatricians, Schools, Nurses, Counselors and Specialists working with children and adolescents.

Test Administration

The psychometric test self-image profile for adults was administered on MS.K.A. The subject was seated comfortably on a chair in room, then proper test material was provided to the subject by screen sharing option andstandardized instructions were given to the subject. All the confusion of the subject wascleared that she had. There was no time limit to complete the self-image profile test, butsubject did not inform of this unless they ask about it. The subject encouraged to do itrapidly as possible.

Quantitative scoring Total scale scoring Scale Name Score Mean ,SD , Cut -off score Self-image^95 129.31,17.71,

Self esteem 53 33.57,14.96, Self-satisfaction^4 9.39,14. Self-certainty negative 1 0.16,0.

Self-certainty positive 0 4.46,4.

Aspects of self-scoring Subscale scoring

Sub scale scoring Scores Mean, SD Outlook 3.25^ 3.96, 0.

Consideration^2 4.57, 0.

Social 3.2 4.57, 0.

Physical 4.3 3.92, 1.

Competence 4.8 3.70, 0.

Moral 3.8 4.83, 0.

Qualitative Interpretation

Client self-image score is 95 which is above from 93 female cut off score with almost 2.5 SD which is above the mean that indicated the client has positive self-image for herself. Client self- esteem score is 53 which is below of female cut off score 64 with almost 1.5 SD below the mean with that indicated that client has high self-esteem. Client self-satisfaction is 4 with 1.5SD above the mean that indicated that client is satisfied withher self. Client self-esteem score is below

self-report instrument which is administered on individuals or groups.

Test Administration

The psychometric test Inventory of Interpersonal Problems (IIP-32) was administered on MS. K. Through online Google meet app. The subject was seated comfortably on a chair in her room, then proper test material was provided to the subject by screen sharing option and standardized instructions were given to the subject. All the confusion of the subject was cleared. There was no time limit to complete the test, but subject did not inform of this unless they ask about it. The subject is encouraged to do it carefully as possible.

Quantitative scoring

Name Raw score T score Controlling 1 47 Self-centered 13 83 Distant 14 83 Social inhibited 12 76 Non- assertive^16 Overly accommodated 10 67 Self – sacrificing 7 57 Needy^10

Total scores^83 Individual Based T scoring

Name Difference Score T-score Controlling

• 36 12 Self-centered 0 50 Distant 0 50 Social – inhibited - 7 38 Non assertive 0 50 Overly accommodating - 16 28

Self-sacrificing -^26 Needy -^5

Qualitative Interpretation Subscale scoring Dominance

The client raw score on this scale is 1 and t score is 47 above SD from mean reflected a problem. A high score on this scale indicates that the person finds it difficult to relax control. Client high score on dominance shows that she is controlling or manipulative. She might characterize her efforts to influence other people as hostile (or even aggressive), but the emphasis here is more on control than hostility. Sometimes a loss of control is threatening to the client because it produces a feeling, she has lost dignity, worth, or self-respect. The client feels that other people are not good and they are manipulative. One goal in treating such people is to help the person clarify the meaning Of losing control and the reason it feels.