PERSONALITY ASSESSMENT INTERNSHIP

BY
Laiba Tasweeb PSYC63F23R023

DEPARTMENT OF PSYCHOLOGY
UNIVERSITY OF SARGODHA,
SARGODHA
2023-2025
 Personality Assessment Internship Case Report

Submitted
TO
Prof. Dr. Mohsin Atta
In The Department Of Psychology
University of Sargodha

Signature____________________

Dated: ______________________
 ACKNOWLEDGMENT

With all feelings of my heart, soul & spirit, I bow my heart before ALLAH ALMIGHTY, who
bestowed me the ability of reading & writing. Then the trembling lips & wet eyes praise the
greatest man of the universe, the last massager of ALLAH, HAZRAT MOHAMMAD
(PBUH). Whose teachings helped me to weather all sort of crises during my life.

On the occasion of the completion of the internship report, it is my pleasant duty to express my
gratitude for all those whose support & encouragement made my task much easier. Well, the list
of people I need to thank will not fit to a single acknowledgement section. I just mention some
people whose contribution is obvious.

My first debt of gratitude & immense pleasure must go to the person behind this internship report
Miss, Zunaira my supervisor and then to my most honorable and respected Proff Dr. Mohsin
Atta. I am very much grateful for his and her constant guidance, valuable suggestions, fruitful
discussion & motivation towards this report. Her enthusiasm, energy & alacrity of thought has
always impressed me & difficult to match up to. I enjoyed every movement of his intellectual
premises. I am fortunate & proud to be part of his group.

My parents & my family members always spared me & sacrificed for my studies. Their wishes
for my success are everlasting. To those who indirectly contributed in this work, your kindness
means a lot to me. Thank you very much.

Laiba Tasweeb
 TABLE OF CONTENT

a) Permission letter
b) Attendance record
c) Case Report 1
Generalized Anxiety Disorder
d) Case Report 2
Persistent Depressive Disorder
e) Case Report 3
Obsessive Compulsive Disorder
f) Case Report 4
Opioids Withdrawal
g) Case Report 5
Down’s syndrome with Intellectual Disability
 CASE 1

CASE SUMMARY

K.T was 20 years old girl. She belongs to a middle class family. She

was suffering from generalized anxiety disorder GAD [300.02 (F41.1)]. She

was a student of M.com at University of Sargodha. She was first born child in

her family. Since 1 years K.T have lost interest in activities of daily life, she

could not concentrate on her studies properly. She failed in two subjects in

mid-term exams in 1st semester of M.com, and in finals too she had so much

difficulty. She thought too much about her worries .These two reasons

triggered her Anxiety. Her Anxiety has become generalized because of her

family cold attitude towards her condition. She often has emotional outburst.

She often thinks that she has no aim in her life. She said that I can’t trust

people because of my worries that they might be bad. She had thoughts like

I can’t do anything and I can’t perform well under my thoughts. She was

unable to perform daily routine task as she feels fatigue all the time. One of

the major problems which evoke her tension was her lack of interest in

studies and lack of concentration during study. The restricted environment of

her family was the maintaining factor. Her supporting figure was her Mother.

For assessing her problems cross cutting measures, BAI and HTP were

administered.
Identifying Information

 Name K.T

 Age 20

 Gender Female

 Education M.com

 Marital Single

status

 Birth First

Order

 Siblings 5

 Parents Both alive

 Religion Muslims

 Residenc Sargodha

Source of Referral

K.T was self-referred to the Fountain House Sargodha for the purpose

of Psychological Assessment and Management.

Presenting Complaints

Table 1

Presenting complaints of the client are given as

Symptoms Duration Presenting Complains

Excessive anxiety 1.5 year ‫مجھے ہر وقت پریشانی‬

‫ہوتی ہے۔‬
Overthinking 1.5 year ‫میں بہت زیادہ سوچتی‬

‫رہتی ہوں۔‬
Difficulty 1 year ‫پڑھائ میں مشکل ہوتی‬
concentrating on
‫ہے۔‬
studies

Restlessness 1 year ‫بے سکونی رہتی ہے۔‬

Muscle tension 1 year ‫پٹھوں میں کھچاو‬

‫محسوس ہوتا ہے۔‬

Sleep disturbance 1 year ‫نیند نہیں آتی ہے۔‬
Fatigue 1 year ‫تھکاوٹ بہت جلدی ہوتی‬

‫ہے۔‬
Feeling of 1 year ‫کچھ کر نہیں پاتی یا‬
worthlessness
‫شاید میں کرنے کے قابل‬

‫نہیں ہوں۔‬
Initial observation

K.T was 20 years old innocent girl. Her hygienic condition was fine. Her

hair seems fine, she was wearing uniform and overall her looks were pretty

normal. She didn’t maintained eye contact properly. Her behaviour was

cooperative as she was answering my question but she was too anxious at

that time. She was a quite girl but answer what I ask. Her speech was low

but she took pauses at emotional points. She doesn’t have any problem like

hallucinations. Her orientation of time, place and person was appropriate.

She was shivering when she is telling me these and even at a moment she

starts crying because she thought that I shouldn’t think more than what a

normal person think.

Past Personal History

She has no psychic history. She completed her developmental miles

stones on time. She doesn’t face any kind of complications during the time of

birth. She was a social girl. She was a centre of attention for all of her

relatives.

History of past illness

She has no past psychological history. She was suffering from anxiety

for more than a year.

Educational History

She was very intelligent and position holder student till 8 th grade in

school. She was loved by all her teachers, her relationship with teachers and

class fellows was friendly but in 9 th grade board examination she failed in two
subjects which was quite shocking for her. After that incident her morale got

down and she started overthinking and getting anxious all time. All

memoires of past educational levels were unforgettable for her either good

ones or bad ones.

Medical history / Drug History

Miss K.T had no medical and drug history.

Accidental history

She has no accidental history.

History of present illness

She was suffering from severe Anxiety since 1.5 years as she failed in

9th grade board examination, she was very intelligent and position holder

student till 8th grade in school. After that incident her morale got down and

she started overthinking and getting anxious all time

Generalized
anxiety
disorder
Family History

Genogram

B1
B2
F

S1

M K.T

S2

Table 2

Key of genogram

Male

Female

Weak relation

Strong relation

Normal relation

M Mother

F Father

B Brother
S Sister

Family psychiatry History

Her family has no psychiatric history. She belongs to a middle class

family. Her parents and siblings have no psychological history. She has 2

younger brothers, and two younger sisters. Her both parents were alive.

Relation of K.T with parents and siblings was not quite normal, because of

her worries her family attitude changes in cold attitude. She was really

protective for her younger sister. She was somehow close to his mother. She

has insecurities about family and life.

General Home Atmosphere

Her home atmosphere was not supporting. She desperately feels the

lack of defending behaviour of her Father. Over the entire home environment

was not what she likes. Due to lack of warmth at home she didn’t shares

much to her family. She had less friends but she don’t share family issues

with them.

Pre- Morbid personality

K.T was an active girl and centre of attention for her family as well as

for all of her relatives. She was very intelligent and position holder. She was

social and has a welcoming behaviour. But after failure in examination she

had changed herself into unwelcoming and defensive personality. Sometimes

she became aggressive and moody girl. She has neuroticism personality but

also openness to experience was present.

Assessment
  Mental Status Examination (MSE)

 Clinical interview ( CI)

 House Tree person ( HTP)

Mental Status Examination (MSE)

K.T has a defensive personality. Her appearance was good with

appropriate dress and had normal cleanliness.

General behaviour and appearance

 Physical appearance

Normal

 Dress

Neat

 Posture

Was not appropriate, she was moving her hands in a way like she was

worried.

 Eye contact

Not consistent

 Social behaviour

Less social

Speech and thoughts

 Tone

Slow and low

 Irrelevant
 No

Mood

Her mood was anxious. She became emotionally disturbed by

remembering the cold attitude of her family toward herself, and the failure

she had in studies. She did cry talking to me.

Affect

Her facial expression was not normal, showing too much restlessness

and irritability. She did feel hesitated in fist two sessions and she was also

cooperative.

Thought processor

Her thought process was good it’s normal.

 Steam of thought

Normal Thought process

 Form of thought

Good

 Content of thought

Good

 Insight/ judgment

Client solves most of the questions easily.

Orientation

Her orientation was appropriate. She has good orientation of place,

person and self-oriented. She is not having any memory issues. She can’t

concentrate properly when she was crying because of her issues.

Insight/ judgment

Client solves most of the questions easily in a normal mood..

Clinical interview

To get depth information clinical method was used. Psychologist ask

questions about his/her personal life, family, social and educational life.
Psychologist also asks about his/her social, interest, friendship, and her

relationship with others. (Quiz let LLc, 2012).

It is most widely used method. It provides a lot of information. It also

reveals many conflicts in personality. K.T was asked about her personal,

social, family and childhood life to access the types of problems the client is

dealing with. Her relationships with others were also explored through

unstructured questions

Clinical Observation

K.T hygienic condition was fine. Her hair seems fine, dress was clean.

She was wearing a uniform. Overall she was not much groomed but normal.

She didn’t maintained eye contact properly. Her behaviour was cooperative.

She was less talkative girl and has less urge to share her moments of life.

Her speech was low and slow but she took pauses at emotional points. She

doesn’t have any problem like hallucinations. Her orientation of time, place

and person was appropriate.

Personality functioning

Her personality functioning seems fine. The tests which were

administrated on the client were cross cutting measures, BAI and HTP. Cross

cutting shows her severe Anxiety and mild level of sleep disturbance. BAI

also represented the same results HTP shows her anxious and aggressive

personality. Anxiety is the most dominant reason that has disturbed her life.
Table 3

Cross Cutting Level 1:

Domain Name Range Obtained Level of

s score severity

I Depression 0-8 4 Moderate

II Anger 0-4 3 Moderate

III Mania 0-8 0 None

IV Anxiety 0-12 8 Severe

V Somatic 0-8 1 Slight

symptoms

VI Suicidal ideation 0-4 3 Moderate

VII Psychosis 0-8 0 None

VIII Sleep problems 0-4 3 Moderate

IX Memory 0-4 4 Severe

X Repetitive 0-8 5 Moderate

thoughts and

behaviors

XI Dissociation 0-4 0 None

XII Personality 0-8 6 Moderate

functioning

XIII Substance use 0-12 0 None

Interpretation of cross cutting level 1:

Adult version of cross cutting assesses 13 psychiatric domains, each

item represent about the frequency of actions or experiences in past 2

weeks, each item scored on 4 point likert scale (0= never to 4=severe/nearly

every day).

Client scored severely high on Anxiety, and moderate on anger,

personality, suicidal ideation, sleep problem, memory and repetitive

thoughts or behaviors. The client is more severe on Anxiety with the highest

score so she was further assessed by level 2 for detailed and reliable

prognosis.

Interpretation of cross cutting level 2:

Level 2 Anxiety

Level 2 of Anxiety was applied to know further details; she scored 29

points on level 2 of Anxiety. The T scores are 71.5 which indicate severe

level of Anxiety.

Table 4

T score interpretation

Less than 55 None to slight

55.0 - 59.9 Mild

60.0 - 69.9 Moderate

70 and over Severe

Level 2 Sleep Disturbance

Level 2 of Sleep Disturbance was applied to know further details; she

scored 30 points on level 2 of Sleep Disturbance. The T scores are 60.4 which

indicate moderate level of Sleep Disturbance.

Table 5
T score interpretation

Less than 55 None to slight

55.0 - 59.9 Mild

60.0 - 69.9 Moderate

70 and over Severe

Level 2 Repetitive Thoughts and Behaviours

Level 2 of Repetitive Thoughts and Behaviours was applied to know

further details; she scored 13 points on level 2 of Repetitive Thoughts and

Behaviours. The average score is 2.6 round of as 3 indicate moderate level of

Repetitive Thoughts and Behaviours.

Beck Anxiety Inventory (BAI)

The BAI consists of twenty-one questions about how the subject has

been feeling in the last week, expressed as common symptoms of anxiety

(such as numbness and tingling, sweating not due to heat, and fear of the

worst happening). It is designed for an age range of 17–80 years old. Each

question has the same set of four possible answer choices, which are

arranged in columns and are answered by marking the appropriate one with

a cross (Beck AT. Steer RA, 1993)

Table 6

Categories of score

Score Range

0-7 Minimal level of anxiety

8-15 Mild anxiety

16-25 Moderate anxiety

26-63 Severe anxiety

Qualitative Interpretation

Her score was 40 which shows ‘’Severe level’’ of anxiety.

House Tree Person

House tree person is a projective test of personality, in which a client is

asked to draw a house, a tree and a person. It was applied on client to

understand different aspects of personality.

 Interpretation of House

Big house Shows Her life revolves around her family. No roofs

Shows Unwillingness to reveal much about herself, concrete orientation.

Absence of door Shows Defensive personality. Absence of windows Shows

Withdrawn and inaccessible or hostile. Absence of pathways this indicate

client is closed and distant. Chimney absent Shows Conflict with specific

male, lack of psychological wellbeing. Faint and sketchy lines Indicates

anxiety. Too much detailing Indicates stress and anxiety. Mountains drawn

Indicates high level of anxiety.

 Interpretation of Tree

In balanced tree Indicates sense of vulnerability and insecurity.

Wide trunk Indicates strong ego. Downward branches Show low level of

energy. Tiny branches Indicates that she experience difficulties of getting

attention. Small top part Shows weak interpersonal relationship with other.

Cloud like tree Shows confused personality. Nest on tree Shows Family

oriented. No roots Shows Feeling of insecurity

 Interpretation of Person

Large head Shows Self-righteous or self-centred. Poorly drawn hairs

Indicates anxiety. Shady drawing Show overthinking and anxiety. Small eyes

Show Introverted personality. Omission of ears Indicate less contact with

environment. Concave mouth Shows passive personality. Absence of neck

Shows Impulsive personality. Spike like fingers Shows aggressive and hostile

behaviour. Tiny feet Indicated dependency.

Case formulation

K.T was 20 years old girl. She belongs to a middle class family. She

was suffering from generalized anxiety disorder [300.02 (F41.1)]. She was a

student of M.com at University of Sargodha. She was the first child of her

family. Since 1 years K.T have lost interest in activities of daily life, she could

not concentrate on her studies properly. She failed in two subjects in mid-

term exams in 1st semester of M.com, and in finals too she had so much
difficulty. She thought too much about her worries. These two reasons

triggered her Anxiety.

Her Anxiety has become generalized because of her family cold

attitude towards her condition. She often has emotional outburst. She often

thinks that she has no aim in her life. She said that I can’t trust people

because of my worries that they might be bad. She had thoughts like I can’t

do anything and I can’t perform well under my thoughts. She was unable to

perform daily routine task as she feels fatigue all the time. She had thoughts

like something bad going to happens. All the time she was worried, can’t

sleep properly, she had restlessness, and irritability in her behaviour. One of

the major problems which evoke her tension was her lack of interest in

studies and lack of concentration during study. K.T is suffering from

generalized anxiety disorder as her symptoms match to the criteria of

generalized anxiety disorder (GAD [300.02 (F41.1)]) in DSM 5.

Following current problems are associated with person’s current

problems.

Predisposing factors

She was healthy by birth. There was no genetic factor behind her

problem.

Precipitating factors

She was upset because she cannot pay attention to her studies and

daily life and whenever she thought about her failure its makes her think that

she will face a failure and she thought too much.

Maintaining factors

Her weak relationship with the family, restricted environment and cold

attitude of her father.

Protective factors

Her mother somehow helps her to overcome and stay clam in stressful

situation.

Presenting
complaints
Summary of Case Formulation
• Excessive
anxiety
• Difficulty in
concentration
• Restlessness
• Muscle tension

Precipitatin Protective
Predisposing g factors Maintaining
factors factors factors
Anxiety
There was no Overthink, Weak relationship Insight of the
genetic factor something with family. Cold problem, her
behind her going to behaviour of her
mother
problem happen, what father and siblings
somehow
I will do then. supports her.
 Assessment tools

 Clinical interview ( CI)

 Mental Status Examination (MSE)
 Cross Cutting Measures (CCM)
 Beck Anxiety inventory ( BAI)
 House Tree person ( HTP)

Management technique
 Deep breathing Outcomes
 Relaxation training Generalize  Better social
 Progressive muscle d Anxiety relationship
relaxation
Disorder  Better sleep
 Stress Management
Training [300.02 (F41.1)]  Better interest
 ACT
MANAGEMENT PLAN

Prognosis

Prognosis seems to be favourable if proper treatment and session are taken

on prescribed days.

There are chances of gradual improvement.

 Short term goals

 Long term goals

 Rapport building

Rapport building is a key element of unconscious human interactions

and good rapport relates to our being effortlessly and positively “tuned into”

the person with whom we are engaging. The dictionary definition of rapport

states: relation, connection, especially harmonious or sympathetic relation; a

sympathetic or harmonious relationship or state of mutual understanding.

Synonyms include understanding, fellowship. Rapport building encompasses

both the verbal and non-verbal aspects of our interactions, some of which

are explicit and some are not.

Effective relaxation techniques for relieving anxiety include

 Deep breathing

When you’re anxious, you breathe faster. This hyperventilation causes

symptoms such as dizziness, breathlessness, lightheadedness, and tingly

hands and feet. These physical symptoms are frightening, leading to further

anxiety and panic. But by breathing deeply from the diaphragm, you can

reverse these symptoms and calm yourself down.

 Progressive muscle relaxation

This can help you release muscle tension and take a “time out” from

your worries. The technique involves systematically tensing and then

releasing different muscle groups in your body. As your body relaxes, your

mind will follow.

 Stress Management Training

Managing stress effectively so that it has no adverse effect on your

body or mind can be termed as stress management. You can yourself

manage it by relieving yourself of excess tension and if your condition is

manageable. Suggested some techniques with which the client can reduce

his stress to some extent. For example; go for a walk, spend time in nature,

spend your time with friends and family members, listen to music and watch

comedy shows.

 Meditation

Research shows that mindfulness meditation can actually change your

brain. With regular practice, meditation boosts activity on the left side of the

prefrontal cortex, the area of the brain responsible for feelings of serenity

and joy.

 Psycho Education

Psycho education refers to the process of providing education and

information to those seeking or receiving mental health services, such

as people diagnosed with mental health conditions. Psycho education, the

goal of which is to help people better understand (and become accustomed

to living with) mental health conditions.

 Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is another problem-

focused talk therapy used to treat GAD. Although similar to CBT, the goal of

ACT is to reduce the struggle to control anxious thoughts or uncomfortable

sensations and increase involvement in meaningful activities that align with

chosen life values. ACT can produce symptom improvement in people with

GAD.
 Session Report

 1ST SESSION

Session goals

 Informed consent

 Rapport building

 Trust development.

 History taking.

 Deep breathing

Activity / techniques

Genuineness was used to develop the trusty relation

Performance

 Her performance was not really good

 Emotional burst out

 Hesitation

 She was shivering and experience shortness of breath

 2ND SESSION

Session goals

 To get information about herself and her family

 Clinical interview

 Performed assessment

 Discuss her problem and their solutions

Activity / technique
 • Cross cutting level 1 and cross cutting level 2 of anxiety, sleep

disturbance, and repetitive thoughts and behaviour were applied, and

House tree person test was administered to get information.

• Counselling

Performance

She hesitate little bit for the HTP test but overall her performance was

good.

 3RD SESSION

Session goals

 Discuss our management plan

 Performed CBT

 Discuss solution

 Follow up about the task given to her

Activity / technique

 BAI were applied to get information.

 Management plan was discussed.

Performance

 Her performance was good

 She was cooperative

 Start to think positive thoughts and know about her issues properly.

Out Come

Before the treatment the client’s condition was not really good. She

had severe level of Anxiety. After the treatment her condition was much
better. She had better sleep and better knowledge about her problems and

their solution to use for the next time. She starts to take interest in her

studies.

Limitations

 The client had inability to regulate her emotions and controlling her

thoughts.

 She had difficulty in making decisions.

 She even has shortness of breath and her body start shivering in cold

sweats.

Suggestion

 Practice relaxation technique

 Think positive about own self.

 Socialize with positive people.

 Use the techniques which she learned when in future she feel anxiety

 Use them as she told.