PSYCHOLOGICAL PSYCHOLOGICAL REPORT I. Identifying Information Name:
Name: "Michelle" Age: 19 years old Sex: Female Address: Calinan, Davao City Birthdate: May 19, 1991 Civil Status: Single Educational Attainment: 4th year Nursing student
II. Presenting Complaint
"Michelle" has been presenting maladaptive eating behavior for almost a year. She keeps her weight in control by restricting on foods, counting calories and running 5 times a week for 1 hour. She secretly engages herself with bingeing, vomiting and excessive exercise.
III. Case Background
"Michelle" "Michelle" is a 19-year 19-year old female female presenting presenting with maladaptive maladaptive eating eating behavior. behavior. She is 5 feet 7 inches tall and weighs 123 lbs. with a small to medium frame size. "Michelle" was born in Digos City. She is the only daughter of three children and has two brothers, ages 21 and 15. According to the client, she rarely eats a normal meal and most mostly ly will will consu consume me a smal smalll amou amount nt of food food durin during g soci social al gath gather erin ings gs.. Howev However er,, wheneve wheneverr she feels stressed stressed or frustr frustrate ated d from from her duty at the hospit hospital, al, she would would consume large amount of foods secretly, which she says is not normal for her daily intake to release stress. But following her overeating, she would feel anxious and guilty over her behavior and lack of control . She would then stick her finger down her throat to be able to vomit. Her preoccupation with weight and body image started way back in high school
in large part of her mother's consistent concern. It then elevated when she was 18 years old and a 3rd year college student in John Paul II College when she gained almost 130 lbs.
According to her, weight, appearance and overall self-worth was an issue that troubled her mother most of her life and was determined to prevent that from happening to her. Whenever they go shopping for clothes or during family dinner, her mother would say harsh criticisms about her body and weight and at other times, making her weigh herself in front of her mother when she says that she doesn't think that she had gained any weight. In addition, her relatives would also say jokes about the amount of food that her mother serves to her during occasions. The client recalled an instance of July of 2009 wherein she lost some weight and was down to about 110 lbs because of her restriction with eating. But she admits that she finds herself craving cakes and cookies, and other "forbidden" foods. But the moment that this forbidden foods passed through her mouth, she would start to feel guilty and would criticize herself. Following this, she would secretly engage herself in vomiting.
At present, "Michelle" has been doing some modeling job and photo shoots for freelance photographers since her boyfriend is a part-time model himself. Her present Body Mass Index is 19.1, which is considered to be normal for her age. And she has never been diagnosed nor hospitalized for her maladaptive eating behavior.
IV. Progress of the Case
July 24, 2010. Before the first session was conducted at the client’s house in Calinan, the interviewer first gathered relevant information about the client’s condition through her boyfriend Boyet and her close friend Nico. The interviewer was already familiar with these people even before the session began. Rapport was already established and data regarding the client’s case were easily given and noted. It was revealed in the interview that "Michelle" (the client) was open about her behavior and would confide this issues with her boyfriend and he r friends as well. She is aware that she has a problem and in fact wants to ask for help but humiliation stops her to do so.
According to Nico (her friend), even though "Michelle" seems as a happy-golucky person she lacks self-esteem when it comes to presenting herself to people. She dreams of becoming a model and she is very thankful that Boyet (her boyfriend) helped her to be a part-time model.
July 31, 2010. Initial interview was conducted at the Center for Educational Measurement in Davao City. Since the interviewer and the client know each other even before the session, it wasn’t difficult to establish rapport. The interviewer first assured that all information given by the client will be confidential and that data gathered will be used for research purposes only. When the interview started, the client was properly groomed and was able to maintain her personal hygiene. She was completely at ease and was able to make good social contact with the interviewer. She showed interest and cooperation during the interview. She speaks both Bisaya, Tagalog and English with a medium volume of voice which the interviewer can understand her clearly. When asked about her condition, she readily admits that she knows that her eating behavior is not normal because she had taken up Psychiatric Nursing, so she knows what is Bulimia Nervosa. After the observation and interview, the interviewer decided to end the session since all relevant information were already gathered. The interviewer scheduled a battery of psychological tests for "Michelle". She agreed right away and decided to meet the interviewer on August 21, 2010.
August 21, 2010. The background of the client’s case was completed based on the gathered information from the client and people close to her. A battery of psychological test was utilized for further assessment of the client’s case. Draw-A-Person Test and Sachs Sentence Completion Test last August 21, 2010.
In summary, test results showed that the client clearly rejects and depreciates her mother while also feeling rejected by her family. Based on the interview, the client's family especially her mother is very critical with her weight and appearance. They would make criticisms and jokes about her weight during dinner or family gatherings. It also showed that she is able to establish meaningful relationship with friends and the opposite sex. Based on the interview from the client and her friends, she is honest about her eating behavior and wants to ask for help especially from her friends. In addition, she is thankful of having Boyet (her boyfriend) in her life and made her fulfill her dreams of becoming a part-time model.
In terms of personality, she has no control over her impulsive behavior with regards of her binge-eating and vomiting. According to her, whenever she feels stressed or frustrated from her duty at the hospital, she wou ld consume large amount of foods high in fat and carbohydrates to release stress. Following her overeating, she would feel anxious and guilty over her behavior and lack of control. She would then secretly engage herself to vomit because she feels afraid that all those calories would make her gain weight.
In addition, it also showed that she is overly concerned with her appearance especially with her body shape. According to her, she is concerned with her shape and weight as aspects of looking good and always worries about how others see her.
August 25, 2010. The interviewer met with the client. The interviewer discussed the results of the psychological test taken by the client and asked further questions or confirmations about it. The client wasn't surprised with the results of her test. She admitted that she has problems with her eating patterns but she is willing to ask for help
especially from her friends. She showed a tendency of blaming her mother for being so critical with her weight. Before the session ended, the interviewer asked the client to answer a quiz as part of their activity entitled The Eating Attitudes Test (EAT-26). The client scored a total of 56 on the EAT-26. Based upon her responses to this eating attitude test, her scores are similar to others who have an eating disorder or at risk for developing an eating disorder. Based from the client's responses on the interview and the test, it shows that she is actively dieting and have an active preoccupation with food that is often associated with bulimia nervosa. She also has difficulty with self-control over eating and vomiting.
V. Analysis
The client (Michelle), was assessed using two (2) Projective Test such as DrawA-Person Test and Sachs Sentence Completion Test and an activity entitled the Eating Attitude Test. After the interpretation of the tests and analysis of the case through interviews and observations with the client and her friends, it was confirmed that the diagnostic criteria in the DSM IV-TR for Bulimia Nervosa was met. Evidences from the client's personal background influenced the cause and onset of Bulimia Nervosa. Her mother and relatives persistent criticisms and jokes about her weight and shape greatly affected and influenced the client's view of herself at present. Her preoccupation with shape and weight as aspects of looking good is in fact her defense because she has low self-esteem that rooted from the criticisms of significant others. She is afraid of gaining weight and judges herself largely in terms of her shape and weight and her ability to control them.
VI. Diagnostic Impression
Axis I
: 307.51 Bulimia Nervosa
Axis II
: None
Axis III
: None
Axis IV
: Psychosocial problem: problems with primary support group (family); criticisms from her mother about her body shape and weight; jokes from her relatives
Axis V
: Current Global Assessment of Functioning: 70 (Has occasional impulsive behavior with binge-eating, vomiting and excessive exercise but is generally functioning well in other areas e.g school; is able to establish meaningful relationship with her friends and the opposite sex)
VII. Prognosis
Good Prognosis. The client is aware of her maladaptive eating behavior (ego dystonic) and is willing to ask for help. There is a good chance of partial recovery of Michelle’s condition. If the client can learn how to deal with her problems of self-image and body weight, she can go on to lead a normal and productive life. But they should give attention to the mother-daughter relationship of the client and her mother which can influence the recovery of "Michelle”.
VIII. Recommendation
The purpose of this psychological testing was to provide assistance for "Michelle" as well as to her parents on what they can do to help her.
Recommendation for "Michelle" future plans are as follows: • "Michelle" should get professional help coming from a clinical psychologist, dietician or nutritionist to facilitate and address her current condition and give proper attention for her treatment. • "Michelle" should seek therapy especially family therapy to address her feeling towards her mother and relatives. • "Michelle" family should avoid making harsh criticisms and jokes regarding her weight and body shape. They should instead make her feel loved and cared for by her family.
______________________________________________________________________________________ This psychological report is based on data coming from psychological tests administered by the Davao Psychological and Testing Center. The graduate student did not have access to the actual psychological report. In keeping with ethical standards, confidential information (i.e, names of persons involved) was made not known to this student.
ATENEO de DAVAO UNIVERSITY GRADUATE SCHOOL
In Partial Fulfillment of the Requirements In C207, PSY 609
Psychological Report And An Epistemological Report
Submitted to: Mr. Ericson D. Batican, MSPsych
Submitted by: Roy Cresencio R. Linao Jr., RN.
Date Submitted: October 28, 2010
EPISTEMOLOGICAL REPORT ON PSYCHOLOGICAL TESTING AND ASSESSMENT
The course introduced to the students the nature, problems and potentials of psychological testing. It was presented with the three basic components of the course namely; a (re)introduction to the basics of psychometrics, an exploration of the psychological idea of what “intelligence” is, and a survey of personality assessment. The topics first started with an the basic principles in testing and assessment that includes a refresher on elements of statistics. Historical aspect as well as cultural, legal and ethical considerations were also discussed within the scope of the course. Topics such as the reliability and validity of a test were also accounted for to ensure the accuracy of the results. How a certain test is conceptualized/constructed were a lso a part of the course. As the course moved on through the semester, many teaching strategies were used mainly reporting on the different topics assigned per student. We were also tasked to give a report on the different testing centers in Davao City. Several battery of test were also presented to us students, for us to know and familiarize ourselves with the different Psychological tests. To have a broader perspective of the course, several reading materials were also provided by the instructor.
