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" is a 19-year old female presenting with maladaptive eating 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

mostly will consume a small amount of food during social gatherings. However,

whenever she feels stressed or frustrated from her duty at the hospital, she 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 her 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-go-

lucky 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 would 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 Draw-

A-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 UNIVERSITYGRADUATE SCHOOL

In Partial Fulfillment of the RequirementsIn

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 TESTINGAND 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 also 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.