Psychological Assessment Report

Name: Mohammad Nihal Ahmed

Father’s Name: Mohammad Ahmed
Date of birth: December 12th 1995
Dates of Assessment: April 15, 16, 18 and 19, 2019
Examiner: Muzamil Abbasi
Case No: 24705

Identifying Information:
Mr. Nihal Ahmed Aged 23 years old single male. He is first born among one brother.
He is currently doing CA from Al-hamd Academy. His father is retired from the jobs
and his mother is a housewife. He belongs to a Muslim Urdu speaking family with
upper middle socioeconomic status. He lives in a nuclear family setup and resides at
Gulshan e Iqbal Block #3 Karachi.
Referral Source:
He is referred by Dr. Hanif Masiha (general physician of Agha khan university of
health sciences) for the purpose of psychological assessment and psychotherapy. His
presenting complains includes: irritability, Low mood, Stress Due to “Irritable bowl
syndrome” “IBS” sleep disturbs, sudden anger outburst and sensitivity toward
everything.
Interview Information:
According to client his problem started four-five years back, when the client parents
got separated he was 16 years old. The client lived with his mother after the
separation of parents. Humiliation from the society after his parents got separated
made him Irritable, because divorce is still a taboo in our society. Separation of his
parent effected his mood he stated to became disturbed, irritable and suffered from
mood swings. after some time, the parent separation issue got resolved but the client
developed IBS "Irritable bowl Syndrome" . His IBS effected his life very much. He
could not concentrate on his studies due to IBS. IBS totally changed his life.
He feels helpless because of his health issues he did not continued his studies & his
grades started falling down. According to client, He could not focus on things related
to studies. He started getting negative thoughts about himself and his health and
repeatedly changing in mood effected his daily life functioning in home in college
and outside home, everywhere he felt embarrassed about himself that why only he
is suffering from that kind of destructing.
According to client IBS is reason behind destruction of his studies and career and he
started getting more stressed day by day. He had physical treatment to cure IBS, but
nothing seems to work to resolving his IBS Issues, then he had conflictful reaction
with younger Brother (Younger 3 years to clients) younger brother always tend to
make fun of client’s health issues. and tend to taunt him regarding his health’s issues.
According to client, parent gave attention and support value to the younger one.
These taunts affect him very badly because According to client he is very sensitive
towards criticism. Parents have fights on daily basis. And according to client those
fight sounds used to make him very uncomfortable.
Because he is so sensitive, he used to avoid these kind of fighting situations which
included shouting, uncomfortable noises, and screams of parents. Fighting of parents
made him felt helpless because he was unable to stop them. According to client he
usually does not engage in any argument or fight with anyone. Client is good in
making and have a good relationship with people. He is inclined more towards his
mother.
Client had a relationship (College Love) that ended 6 months ago. After break-up he
became more stressed which made his IBS more sever. Negative thoughts started
appearing, one of them was the thought of suicide, and started regretting himself
about past and past relationships. According to the he wasted his time in a
meaningless relationship.
Most of the time he (client) feels tired. Going gym and jogging does not attract him.
Sleep patterns of client intake due to medicines which he is taking, referred by his
physiotherapist Dr. Hanif Masiha. The client relates more to smart and intelligent
people. Nowadays he is not engaged in friendship or social activities though the
client is talkative from last few months he is not concentrated in anything. The client
passes low intake memory. According to client he has guilt over academic
performance. He suffered from crying spells sometimes he feels easy & comfortable
after crying.
The client usually has an head ache and tensions related to future, then he thinks
about the future he bacame passive aggressive the client has inside about on his
problems. He wants to get rid of IBS as soon as possible.

Test Administered:
Human figure drawing....................(HFD)
Bender gestalt...................................(BG)
Standard Progressive matrices........ (SPM)
Thematic Apperception Test.............. (TAT)
Rorschach Inkblot Test......................... (ROR)

Behavior During Testing Sessions:

During assessment sessions Mr. Nihal responded well to questions. He was not
maintaining the eye contact with examiner but he responded well on psychological
test, he speaks in a soft tone. He constantly posses a smile on his face throughout
session. He was very much interested and curious about all the testing procedures
before each test. During session he seems to be active but before session he seems
tired and lazy.
Psychological Evaluation:
Psychological Evaluation of projective test HFD reveals that the client has anxiety
related to his body, sensitivity towards his criticism, need for affection. Further it
reveals insecurity dependences feeling of dejection and sexual conflicts and
obsession.
Bender gestalt a neuropsychological screening test reveals that Mr. Nihal Visual
motor perceptual functioning call within average range emotional indicator indicate
impulsivity and acting out behavior

Result of standard Progressive matrices a test of non-verbal abstract reasoning which

is one aspect of intelligence shows that Mr. Nihal Intellectual capacities fall within
below average range.
Projective analysis reveals that Mr. Nihal has feeling of inadequacy and feels
conflicted regarding self-image. His protocols show prominent need for succorance,
need for aggression and need for affiliation. In this respect he perceives his
environment as stressful and unfavorable. His main conflicts are associated with
affiliation versus isolation, intra versus extra aggression and success versus failure.
His anxieties are related to lack or loss of love and being helpless. To cope with
conflicts and as a primary means of reducing the resulting anxieties he majorly uses
the defense mechanisms of rationalization, repration undoing fantasy & denial.
Projective analysis further reveals that he seems to be immature. He has stereotypical
manner of approaching the world which leads to difficulties in interpersonal
relationship. He is governed by the needs and urges and he has difficulty in delaying
gratification therefore rarely plan toward "long term goals. He expends less effort
than needed to adequately process information which made him anxious and
preoccupied with negative thoughts. Moreover, he sacrifices the full use of
Intellectual Potential by merely focusing on the safe and obvious aspect of situations
Further analysis indicates that he has poor emotional control and his interactions are
likely to be sensitive towards criticism. which negatively affect interpersonal
relationship. He feels overwhelmed and unable to deal with complex situations and
shows impulsive behaviors. He has fewer than average resources to adequately cope
with stressful situation. He has ego functioning, he has depressive symptoms with
low suicidal ideation and he has perceptual patterns of thinking and obsession.
Tentative diagnosis:
296.22 (0F32.1) Major Depressive Disorder with anxious distress.

Prognosis:
On the basis of his psychological assessment and intellectual functioning his
prognosis seems to be fair.

Recommendations:
Following are the recommendations that might help improving the client's
functioning.
  Cognitive behavior therapy is recommended for client to work on his
cognitive errors.
 Cognitive restructuring will be helpful to modify cognitive distortions as well
as the underlying intermediate and core beliefs.
 Psycho educate client about maladaptive coping strategies to replace it with
solution focused coping strategies in order to help him solve problem
effectively
 It is necessary to alter client's maladaptive coping style in order to help him
solve his problem with effective strategies.
 Assertive training will help him to deal effectively within interpersonal
domains of functioning.

Supervisor: Examiner:
Madam. Ayesha Zia Muzamil Abbasi