Psychological Case Study: John's Assessment, Diagnosis, and Treatment

This case study presents the psychological assessment of John, a 45-year-old carpenter experiencing headaches and muscle pain, leading to an inability to work. The assessment incorporates a life story interview, the NEO PI-R personality inventory, and the Thematic Apperception Test (TAT). John's family history reveals a predisposition to mood disorders. The results from the NEO PI-R indicate high scores in neuroticism and introversion, correlating with his current struggles. The TAT results suggest the use of defense mechanisms like denial, projection, and identification. John's history of workplace stress, financial strain, and physical ailments contributes to his depression and anxiety. The case study highlights the interplay of genetic predisposition, environmental stressors, and personality traits in shaping John's psychological state, providing a comprehensive understanding of his condition.

Running head: A CASE SUMMARY
A Case Summary
Name of the Student
Name of the University
Author note

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A CASE SUMMARY
Case history of John
John is 45-year-old man who is living with his family. John was referred to the Monash Medical
centre with the history of headache and muscle pain in the legs that he was forced to leave his
job as a carpenter. John is an English Carpenter who is has come with the problem of major
muscular pain and has problems in sitting and while walking. He is well oriented and well
perfuse. There was no abnormality found while looking at him in the first place.
Predisposing factors
John has a very strong family history, which predisposes him to develop a mood disorder.
According to Levinson et al. (2014), a large sample of people diagnosed with non-anxious
control and general anxiety disorder showed the family history of the psychological
problems. As per the behavioural genetics research, metal disorders are highly
attributed to genetic factors. John’s cousin was suffering from Bipolar Disorder and
John’s sibling has posttraumatic stress disorder. However, it is evident that John has a
strong genetic history that can influence the psychological condition of John.
Biography of Psychological Assessment
It has been seen through several researches that the psychological assessment tests are very much
similar to the medical tests. The patients when have their medical symptoms are given certain
blood tests or physical examination tests that are helpful to understand the cause of the
symptoms of the patient (Zacher, 2014). The results of the tests are the will always help the
physician to develop a current plan of the treatment. The various psychological evaluations are
done for the mental well being of the patients that more or less serves the same purpose. The

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psychologist uses the tests and the other form of the assessment tools that are used for observing
the behaviour of the client and hence they can come to the proper diagnosis and the guide for the
treatment of the patients (Staff, Hogan & Whalley, 2017). The psychologists administer the
various forms of tests and the assessments for the wide range of reasons. The children who are
facing problems in reading and writing, the workers who are facing several problems in their
workplace or any other person who have their problems that are generally and anxiety can be
assessed by the various test reports and assessment techniques that are implemented by the
psychologists (Bryman, 2015).
The personality tests are the most common form of test or measures that assess the
characteristics of the individual that are not influenced by the belief and that are said to be on the
independent form of the bias. The objective forms of the tests are actually the measures of the
characteristics of the individual through the assessment processes. The personality tests are
generally reflective and the assessment results reports their true personality
Description of the tools
There are three types of tool that was implemented on the patient to know their true
personality report. The three forms of tools that were used for this study was NEO PI R, Life
story interview and Thematic Apperception Test.
Firstly, life story report is the interviews that are done on the client where he/she have to tell the
psychologists about their life story. The social scientists have always interested to hear about the
stories of the past of the individuals and about the plans that they want to accomplish in their
future. The client is asked to focus on the key questions that are asked by the psychologists about

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their past. They needs only focus on the scenes, characters and the ideas that are asked by the
psychologists to them (Zacher, 2014). There are no right or wrong to the answers to the
questions. Their task is to tell about the past incidents and to imagine their future. They have to
cover the areas such as high point, low point, turning point, positive form of the childhood
memory, negative childhood memory and vivid form of adult memory in their life history
(Bryman, 2015). They also need to focus on the several challenges of their life and they need to
overcome those challenges in a day-to-day basis.
The NEO PI R, is the second tool that are use for the assessment of the personality of the client.
It is a standardized form of questionnaire and it provides a systematic form of emotional,
experimental, motivational and the attitude styles with a detailed way of the description of the of
the personality. The Neo PI R is the concise form that consists of the five main domains of
personality that have the six major form that defines each type of the traits of the personality.
The shortened version of the Neo Five factor inventory is comprised of 60 items that have 12
items per domain. Both the inventory Neo PI R and Neo FFI are been updated from a longer
period and it has been finally updated in the year of 2010. The Neo PI R assesses the big five
form of the personality traits that includes the Extraversion, Openness, Agreeableness,
Conscientiousness and Neuroticism. However, the inventory assesses the six form of the
subordinate form of the dimensions that have the factors that are related to the factors of the
main personality. Paul Costa Jr and Robert MaCrae have developed the test that can be used by
the adult men and the women without the overt form of the psychopathology.
The third type of assessment that are used for the study is the Thematic Apperception Test
apperception test or TAT is one of the projective technique, which measures and evaluate the
patterns of the person’s attitudes, the patterns in which they think, emotional responses to the test

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materials that are ambiguous. TAT is the example of the instrument of projection that helps the
person to project their thought process and emotional responses. The TAT measures the three
forms of the defence mechanisms that include the denial, identification and projection. The
individual’s thoughts and history of the defense mechanisms used are analyzed in the stories that
are told by them by seeing the cards. The discrete dimension of the scale analyzes the social
cognition and the object relationship of the observation of the patient. The complexities of the
representation of the people are affected by the tone of the relationship, the moral standards and
the understanding of the casualty of the society.
Results
John scored a raw score of (N = 1300 on the Neuroticism scale (N), t= 78
On the Neuroticism Scale (N), John scored an raw score of N = 130, t= 78
Andy scored “very high” on the Neuroticism Scale (raw score (N) = 130, t=78)
Interpretation of the data
In case of the TAT test, it has been observed that the client was pulling two cards that
shows the card that was pull out was for the defence mechanisms. From different forms of
studies, it was clear that the different TAT cards pull for different defences. These findings
provide the indication that the cards might be especially likely to pull the particular form of the
defences. Results indicate that two cards (3BM, 8BM) are likely to pull for denial. These two
cards both include a gun in the picture, which perhaps accounts for the use of the defence to
disavow this potential threat (Ispas et al., 2014). Cards 3BM and 8BM also pull for projection, as
do 6BM, 15, and 18GF, but these latter three cards are quite different in content and do not

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provide any clear explanation for their elicitation of projection. Cards 1, 2, 6BM, and 7BM all
pull for identification. Cards 1 and 2 both suggest the presence of cerebral activity or work.
Cards 6BM and 7BM both include two figures, each dyad representing older and younger people
who are avoiding interaction, perhaps indicating both affiliation as well as the need for personal
differentiation. These features could be seen as contributing to the defence of identification. The
findings also suggest that some TAT cards are relatively neutral in terms of pulling for defence
mechanisms.
The report of the life story report suggests that the client has various forms of insecurity due to
his past events. The problem of mood disorders and prevalence of neuroticism are found
vehemently in his family history.
John has a very strong family history, which predisposes him to develop a mood disorder.
According to Levinson et al. (2014), a large sample of people diagnosed with non-anxious
control and general anxiety disorder showed the family history of the psychological
problems. As per the behavioural genetics research, metal disorders are highly
attributed to genetic factors. John’s cousin was suffering from Bipolar Disorder and
John’s sibling has posttraumatic stress disorder. However, it is evident that John has a
strong genetic history that can influence the psychological condition of John. John
suffered a spider bite developed cellulites, ruptured his anterior cruciate ligament,
surgery on anal fistula and diagnosed of osteitis pubis. He has been also suffering from
workplace stress factor, workplace bullying, severe loss of functioning, no work capacity, loss of
significant support from work and family. He has been also suffering from financial strain is the
major perpetuating factor for his depression and anxiety.

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The third tool that was used on the client to know about his personality trait was the NEO
PIR. From the results of the NEO PI R inventory, it was found that the client is has scored higher
in the neurotic facet and introversion facet. This is because the type of environment he is living is
bound to give him the problems and make him inclined towards depression and anxiety. It has
been observed from the life history analysis of John that he is suffering from huge financial
crisis. Therefore, it is very much obvious that he is inclined towards depression. Moreover, his
genetic history also portrays that there is a bipolar disorder and mood disorder history in his
family. Therefore, the NEP PI R scale shows that he has scored higher in Neuroticism scale.
From the case study, it has been observed that the various forms of the inventory tools
helps the psychologists to know about the personality traits of the person.

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