NORMINDA DAWAG, M.D.

, FCLPP,FPA3MI
PSYCHIATRIST
Sino Ang Dakila Sino Ang Tunay Na Baliw Medical Clinic
(SADSATNB Medical Clinic)
Suite 333 The Medical City
Ortigas Ave., Ortigas Center, Pasig City
========================================================================
June 10, 2015
PSYCHIATRIC EVALUATION

GENERAL DATA: Edward Cullen, is __ years old, male, Filipino, married, Roman Catholic. He
is a call center agent. He is residing at 1234 Tiktik Street, Barangay Seattle, Makati City. He
first came for psychiatric consultation and examination April 3, 2015 and came in regularly until
mid-June 2015.

CHIEF COMPLAINTS:
Pinayagan ko na syang tuluyang umalis sa bahay because she always leaves the house
without saying a word
Nasiraand cellphone ko dahil binato to sa sobrang galit. Paulit ulit ko syang tinatawagan pero di
nya sinasagot
Kahit anong gawin ko, hindi naman siya masaya. Parang laging kulang ang mga ginagawa ko.
Nawawala na ang pagiging lalake ko kapag nagaaway kami hanggang dumating sa point na
siguro nagkasawaan na at unti unti na kami hindi nagusap hanggang tuluyan nang nasira.
Yung isa pa niyang palaging problema sa akin yung pagcocosplay ko. Ano ba ang masama
kung dun ko nararamdaman na tanggap ako at may point naman ang buhay ko. Kahit anak
namin kapag sinasama ko sa mga cosplay event ko natutuwa naman.
Sa pagkakaalam ko wala namang ibang lalake. Sa akin naman, walang ibang babae. Kaya
mas masakit yung mga nangyari sa amin kasi wala kami ibang masisisi kung hindi ang isat isa.

according to client.

Informants:
1. Edward Cullen, Petitioner
2. ____, Petitioners mother
Reliability:
Fair
Previous Illnesses:
Medical: He has no medical history such as Cardiac disease, Hypertension, Asthma, nor
Diabetes
Psychiatric History: Consult was done with a Psychiatrist, but he did not take any medications
as prescribed
(+) self mutilating behavior
(+) history of poly-substance abuse (alcoholic beverages, marijuana, benzodiazepines
downers)
(+) history of child abuse (physical)
(+) history of broken family

Alcohol and Drug history: He has smoked cigarettes and abused alcoholic beverages

PERSONAL HISTORY:
Prenatal and Perinatal
Edward is the third of five (5) siblings, he was born via normal spontaneous delivery in
Makati City. There were no known complications, after his birth. The pregnancy was planned
and wanted.
Edward grew up with his father but his parents separated when he was only 5 years old.
He witnessed how his father battered his mother. His father left their home. His mother raised
him and his other siblings. Later on, she had another relationship.

Early Childhood (0-3 years old)

He was not breast fed. Early development milestones such as walking, talking were at
par with age. Language and motor development were normal.

His stepfather also left his mother.

His mother was an office employee. She was often seen drinking.
Discipline was inconsistent as her drinking left her moody.

Middle Childhood (3-11 years old)

He was cared for by his maternal grandmother while his mother was working. His other
relatives live nearby.
At 6 years old, he was enrolled in Forks Grade School in Makati. He had above average
grades. He was sociable. He involved himself in most of the school activities. He joined
competitions (declamation, singing, dancing, basketball) even if he knew he has no talent to
win. He also joined the tennis team. He was uncomfortable when he was not in the center of
attention.
Edward preferred to stay out of the house than be with his family.
He recalls at 11 years old he insisted in joining a group of boys brotherhood. He had
undergone hazing but did not tell anyone.
At home, he helped do the household since his mother is always out for work.
He observed his mother to be home, tired sitting in front of the television drinking beer
every night, and smoking cigarettes. He did not communicate with his mother. He was afraid
that his mother might have some form of outburst.

Late Childhood (puberty to adolescence)

Edward was enrolled in Forks High School he wanted to enroll in Spoons International
High School but he was unable to due to financial constraints. He had average grades. He
continued to be sociable.
He was not close to his family. He kept to himself.
Expression was discouraged. He was tasked to care for his mother who was an
alcoholic and occasionally experienced alcoholic black-outs.
At 16 years old, while she was in his 4th year high school, Edward was out with friends
after school hours in a nearby McDonalds branch. They were offered to apply for a part time
job.
Edward was offered to work as a crew in a food chain.

Despite the busy schedule in school and work, he had time to indulge in drinking and
using marijuana with his friends.
Edward helped support his family, through his part time job.
At 18 years old, he had a relationship with his co-worker but it did not last long. They
always argue due to the formers jealousy caused by his fear of losing her as his girlfriend.

Adulthood
There were times Edward stayed in his room contemplating on hurting himself, for no
apparent reason. He felt hopeless and worthless. He failed to take care of himself and even
grown his beard. He resigned from work without any reason. He consulted with a Psychiatrist
through a phone interview. He was given medications Lexotan. Edward was not compliant.
He frequently experience mood swings.
He recalls being unable to finish most of the tasks he started, and his thoughts racing
with different new ideas. He enjoys those times when he is euphoric.
There are times when his life is a plateau. He made things happen so that he could
experience something unusual. He is not used to a harmonious environment, which he
considers boring.
Since college, he has a strong interest in Costume Play (Cosplay). It made him feel like
he was in a different, better world. He felt accepted and appreciated by his peers.

MARITAL AND RELATIONSHIP HISTORY

Edward and Bella met in college as they were blockmates, both taking up B.S. Biology at
Twilight University. .
He liked it that Bella was easy to get along with. She was smart and witty. Her family
lived in Makati. Bella gave him much attention. She would call and text him all of the time.
Since Bellas family was more well-off than Edwards, she did not need to get a part time
job. Hence, there were times Bella demanded more time from him. He felt suffocated but tried
to tolerate and understand her.
Bella, when bored, would go out with her friends without informing him.
After college, Edward started working at a call center while Bella entered Medical school.
Despite Edward being well-compensated at work, Bella still kept on bugging Edward to take
further studies or to at least explore other opportunities.

Edward proposed to Bella on their 5th Anniversary and got married the year after on
August 19, 2006.

After the wedding they lived together in Edwards family home as they did not have
enough savings yet to purchase their own house.
.
Their marriage was never perfect nor ideal, not even from the start. But Edward always
hoped that something would change along the way.

After they got married, they had difficulty in conceiving largely due to their schedule
conflicts, stress, and fatigue. When they finally had Renesmee in 2012, Edward thought she
would be their saving grace, the solution he has been praying for. Unfortunately, Renesmees
birth did nothing to change the carefree and whimsical attitude of Bella. Hence, Edward was left
with the responsibility to take care of Renesmee. Edward felt unwanted and abandoned but
despite of this, found meaning and direction with the birth of his daughter.

PHYSICAL EXAMINATION
No pertinent findings on examination

PSYCHOLOGICAL TESTS TAKEN BY EDWARD CULLEN

General Mental Ability Test
House-Tree-Person
Draw-A-Person Test
Basic Personality Inventory
Gender Gestalt Visual Motor Test
Luscher Full Color Test
Self-Analysis
Zung Depression Scale

DESCRIPTION OF PSYCHOLOGICAL TESTS USED:

The Projective Drawings were used to elicit psychopathology of the client.

They also reveal the clients views of himself, on sexuality, beliefs, principles and family
orientation.
The Bender-Gestalt visual motor test, elicits any form of psychosis, such as auditory
hallucination, delusions.
The Luscher color test reveals the clients desire, dreams, fantasies, coping skills.
The Zung Deppression Scale, is used to elicit any forms of depressive tendencies.
The Basic Personality Inventory (BPI) is an innovative, multiphasic personality
assessment intended for use with clinical and normal populations to identify sources of
maladjustment and personal strengths. The BPI can be used with both adolescents and adults,
and is completed in half the time of other measures. The BPI measures twelve (12)n distinct
psychological traits. Scale names were chosen to avoid potentially inaccurate diagnostic labels
while emphasizing construct dimensions of psychopathology. The BPI makes use of the
sophisticated procedures to minimize susceptibility to the social desirability response basis. It is
sensitive to the tendency to describe Cullens oneself in favorable (fake-good) and unfavorable
(fake-bad) terms. The easy reading level makes it suitable for a variety of populations.
The Mental Status Examination, is an interview that reveals the clients mood, affect,
thought process, thought content, memory impairment, abstract thinking, visio-spatial ability,
judgment, and insight.

Psychological Test Result

Edward has an intelligent quotient classified as Average.
Subject is fascinated with the idea of idealized associations of tenderness and mutual
enchantment. She wants to be identified with someone or something that exists but must not be
allowed to appear, all approaches are made with caution.
He is disappointed with unfulfilled hopes that give rise to anxious uncertainty, while
doubts that things will be any better in the future leading to postponement of essential decisions.
The conflict between hope and necessity creates considerable pressure. He immerses himself
in trivialities to escape his problems.
He needs warm companionship but is intolerant of anything short of special
consideration from those close to him. If this is not forthcoming he is liable to shut himself away.
He is easily suggestible, and affected by his environment, at times readily removed by
the emotions of others.
He sees his mothers faults but accepts and tolerates their differences.

He resents his father, and wishing they had a closer bond.

He has isolated and rejected her past relationship.
Male is more dominant than female.
No brain damage, nor psychotic symptoms noted.
Moderate depression on Zung scale.
Defenses utilized are denial, acting out, distortion, idealization, introjections.

INTERVIEW OF ESME CULLEN

October __, 2015
Relation to the petitioner mother
Esme is __ years old, female, separated with ___ Cullen since ____.
Esme mentioned that Edward is the second child in the brood of three. His biological
father is ______. He left his family after realizing that his marriage ____ will no longer work.
Their marriage lasted to _____ years. She had another relationship but did not last long. She
neither filed an annulment nor a legal separation suit.
While Edward was a child, he was described as pasaway. He ran around the
neighborhood and stayed out of the house until late in the evening. ______ supported her
children together with her mother.
Edward finished his high school, until later he helped in supporting their family through
part time jobs.
During his college years, he tried to communicate with his father to ask for financial
support since he really wanted to be a doctor after finishing his undergrad course.
After graduation, he looked for a job and save some of his earnings.

MENTAL STATUS EXAMINATION OF EDWARD CULLEN

Edward is an adult male, in polo barong, and trousers. Shy, timid, and reserved. He is
cooperative to queries. Mood is labile. Affect appropriate. He described himself as always
needing to know the answer to why are these happening to me? He recalled his failed
marriage with Bella. He described his anger when he cannot get any good answer from Bella as
well as his mood swings. He warned undersigned to be available anytime when he needs some
consultation and undergoing depression. He feels that he has nothing more to offer to the world,
looks down at himself for being a failure as a husband. Speech is spontaneous with relevant

remarks. He denies perceptual disturbances such as auditory or visual hallucinations. Though

process is goal-oriented. Memory is recent and remote memory is intact. Behavior is socially
appropriate. He has faulty test judgment. He has fair insight. Reliability is fair.

DIAGNOSTIC IMPRESSION OF EDWARD CULLEN

AXIS I -

Partner Relationship Problems

T/C Ansiety Disorder
Poly-substance Abuse

AXIS II -

Histrionic Personality Disorder

With Narcissistic Features

AXIS III -

No known medical condition

AXIS IV -

Primary support group (Dysfunctional family)

AXIS V -

Global Assessment of Functioning 92

DIAGNOSTIC IMPRESSION OF EDWARD CULLEN (Based on DSM-5 (Diagnostic and

Statistical Manual of Mental Disorders) Criteria)
Mr. Cullen demonstrates pervasive pattern of excessive emotionality and attention
seeking, beginning in early adulthood and present in variety of contexts, as indicated by
five (5) or more of the following:
1. Is uncomfortable in situations in which he or she is not the center of attraction.
a. Example: (Actual actions ni MR Cullen )
2. Interaction with others is often characterized by inappropriate sexual seductive or
provocative behavior.
a. Example:
3. Displays rapidly shifting and shallow expressions of emotions.
a. Example:
4. Consistently uses physical appearance to draw attention to self.
a. Example:
5. Has a style of speech that is excessively impressionistic and lacking in detail.

a. Example:
6. Shows self-dramatization, theatrically, and exaggerated expression of emotions.
a. Example:
7. Is suggestible (Easily influenced by others or circumstances.
a. Example:
8. Considers relationships to be more intimate than they actually are.
a. Example:
Final Diagnosis
DSM-5: Personality Disorder HISTRIONIC

REMARKS:
Based on the interview and examination of Edward Cullen and interview of ________,
the petitioner is suffering from a HISTRIONIC PERSONALITY DISORDER, this is characterized
by a pervasive pattern of attention seeking, dramatic and inappropriate behavior, impressionistic
speech, overly concerned with physical attractiveness, uncomfortable in situations where he is
not the center of attention, perceives relationship to be more serious than they really are.
Poly-Substance abuse diagnosed.
Edward did not grow up in a nurturing environment.
His father left them while he is still young. His mother rarely communicates with him.
From childhood, it was him who took care of his mother who was known to be alcoholic.
Parenting was inconsistent.
He was not motivated by role models. His father beats his mother when they are having
heated arguments.
He was very interested in school but he was also influenced by his friends and even
invited to have drinking sprees and use marijuana.
He was physically abused when he joined a group of boys whom he taught would be his
good friends and would always be there for him. He was unable to inform his mother about this
due to fear of being grounded.

He received the attention he needed when he was in school.

His conflicts were unresolved.
He sought the company of those who he wanted identify him as someone for he felt he
does not have an identity of his own.
Manic depression state is a reflection of childhood failure to establish internal objects.
Depressed people have never been able to overcome depressive position common to
childhood. The depressive position is reactivated as a result of losing a loved one.
His childhood caused him Melancholia because of the loss of a significant figure, and
an inconsistent mother figure. He feels a profound loss of self-esteem, accompanied by self
reproach and guilt. He acts out because of the rage directed towards himself.
His manic defenses such as idealization, denial, have developed in response to the pain
of lost love objects.
His coping mechanisms were carried on the adulthood.
He is genetically predisposed to depression and substance abuse. His mother was an
alcoholic.
The root cause of his dysfunctional family, which manifested in early adulthood.

RECOMMENDATIONS:
Based on the above findings, it is therefore recommended that Edward Cullens
marriage to Bella Swan be declared null and void, on the basis of his psychological incapacity to
handle essential marital obligations manifested during early adulthood. The root cause is her
dysfunctional family and environment. His personality disorder is GRAVE and INCURABLE.
The defenses and coping skills were learned as the petitioner was growing up, which
means this cannot be undone, since the personality disorder is ego-syntonic. The psychological
incapacity, having been anchored on his personality, is incurable.
A personality disorder is developed over a long period of time, typically from early
childhood. It is deeply entrenched in a person, such that the person feels very comfortable with
it that she does not think that it is a problem. A person with such personality disorder is unable
to acknowledge the existence of the problem therefore professional help is of no avail. Being a
Medical Doctor, there is no drug or form of therapy, to date, nor has there been any controlled
studies reported which found an effective treatment for the Histrionic Personality Disorder.
The petitioner is genetically predisposed.
personality disorder.

Poly-substance abuse and histrionic

NORMINDA DAYAG, M.D., FCLPP, FPA3MI

Psychiatrist