Ayesha case marital harrasmnet and bulliyng

SOLVED:

1. Social Adjustment Scale (15 items) – Sample Responses & Scoring

Instructions Recap:
1 = Never true, 2 = Rarely true, 3 = Sometimes true, 4 = Often true, 5 = Always true

Item	Statement	Response (1–5)	Interpretation
1	I feel comfortable meeting new people.	2	Rarely comfortable, reflects social withdrawal
2	I get along well with my colleagues/classmates.	3	Sometimes gets along, moderate social adjustment
3	I can share my feelings with close friends or family.	2	Rarely shares feelings; low emotional support
4	I find it easy to adjust to new situations.	2	Rarely adapts; low adaptability
5	I enjoy spending time in social gatherings.	2	Rarely enjoys social interactions
6	I can solve conflicts with others calmly.	3	Sometimes able to handle conflicts
7	I feel supported by my family or friends.	3	Some support from sister, otherwise limited
8	I can work effectively in a group or team.	3	Moderate; anxiety may interfere in groups
9	I feel confident expressing my opinions in public.	2	Low confidence; social anxiety present
10	I maintain good relationships with neighbors or community members.	3	Moderate; avoids interactions due to fear
11	I rarely feel left out in social situations.	2	Frequently feels left out
12	I can manage stress when facing social challenges.	2	Low coping ability for social stress
13	I try to understand others’ feelings and problems.	3	Sometimes empathetic, but avoids deep social engagement
14	I feel accepted by the people around me.	2	Rarely feels accepted
15	I am satisfied with my overall social life.	2	Low satisfaction; restricted social support

Scoring:

• Sum of all items: 37/75

• Interpretation: Low social adjustment; struggles with interpersonal relationships and social integration, consistent with her history of abuse, anxiety, and withdrawal.

2. Ten-Item Personality Inventory (TIPI) – Sample Responses & Scoring

Instructions Recap:
1 = Strongly Disagree … 7 = Strongly Agree

Ayesha’s Responses (based on case history):

Item	Statement	Response (1–7)	Interpretation
1	Extraverted, enthusiastic	2	Low extraversion; social withdrawal
2	Critical, quarrelsome	3	Slightly disagree; cooperative but sometimes irritable
3	Dependable, self-disciplined	5	Average conscientiousness; maintains responsibilities
4	Anxious, easily upset	6	High neuroticism; anxious and emotionally reactive
5	Open to new experiences, complex	3	Low openness; avoids change
6	Reserved, quiet	6	Low extraversion; prefers staying quiet
7	Sympathetic, warm	5	Average agreeableness; cooperative and caring
8	Disorganized, careless	3	Slightly disagree; somewhat organized
9	Calm, emotionally stable	2	Low emotional stability; high neuroticism
10	Conventional, uncreative	5	Slightly agree; prefers routine and familiar

Scoring:

• Neuroticism: Items 4 + reversed 9 → 6 + (8–2=6) = 12 → High

• Extraversion: Items 1 + reversed 6 → 2 + (8–6=2) = 4 → Low

• Openness: Items 5 + reversed 10 → 3 + (8–5=3) = 6 → Low

• Agreeableness: Items 2 + 7 → 3 + 5 = 8 → Moderate–High

• Conscientiousness: Items 3 + reversed 8 → 5 + (8–3=5) = 10 → Average

Interpretation:

• High Neuroticism: Emotional vulnerability, anxiety, mood swings

• Low Extraversion: Social withdrawal, limited assertiveness

• Low Openness: Resistance to change, prefers routine

• Moderate–High Agreeableness: Cooperative, avoids conflict

• Average Conscientiousness: Maintains basic responsibilities

Ayesha’s Sample Responses:

Item	Symptom Statement	Response (0–3)	Interpretation
1	Sadness	2	Frequently sad
2	Pessimism	2	Often feels hopeless
3	Past Failure	1	Occasionally feels like a failure
4	Loss of Pleasure	2	Reduced interest/enjoyment
5	Guilty Feelings	2	Feels guilty/blames herself for issues
6	Punishment Feelings	1	Sometimes feels she deserves punishment
7	Self-Dislike	2	Frequently dislikes herself
8	Self-Criticalness	2	Often self-critical
9	Suicidal Thoughts	0	No active suicidal thoughts
10	Crying	2	Frequently cries
11	Agitation	2	Often restless or irritable
12	Loss of Interest	2	Decreased interest in activities
13	Indecisiveness	2	Difficulty making decisions
14	Worthlessness	2	Often feels worthless
15	Loss of Energy	2	Fatigue and low energy
16	Changes in Sleep	2	Poor sleep quality
17	Irritability	2	Frequently irritable
18	Changes in Appetite	1	Occasional appetite changes
19	Concentration Difficulty	2	Difficulty concentrating
20	Tiredness or Fatigue	2	Often tired
21	Loss of Interest in Sex	1	Slight loss of libido

Scoring:

• Total Score: Sum of all items = 37/63

• Interpretation: Moderate depression (score 20–28 is moderate; 29+ is severe)

• Clinical Meaning: Ayesha experiences clinically significant depressive symptoms, including sadness, hopelessness, fatigue, self-critical thoughts, and social withdrawal, consistent with ongoing domestic abuse and low social support.

RAVEN STANDARD PROGRESSIVE MATRICES — ANSWER / SCORING SHEET

Name: Ayesha
Sex: Female
Age: 28 years
Class / Education: Secondary / Intermediate level (replace if different)

Test begun: 19-May-2025, 10:00 AM
Test ended: 19-May-2025, 10:35 AM
Total time: 35 minutes

Item No.	A	B	C	D	E
1	✓	✓	✓	✓	✓
2	✓	✓	✓	✓	✓
3	✓	✓	✓	✓	✓
4	✓	✓	✓	✓	✓
5	✓	✓	✓	✓	✓
6	✓	✓	✓	✓	✓
7	✓	✓	✓
8	✓	✓	✓
9	✓	✓
10	✓	✓
11	✓
12	✓

Notes on table marking:

• A full column represents 12 items per set (A–E).

• ✓ indicates the item was answered correctly. (This pattern yields 42 correct items.)

---

Total raw score: 42 / 60

Percentile (approx.): 50th–60th percentile (age 28 norms) — Average intellectual functioning

Discrepancies:

• No major intra-test inconsistencies detected. Performance declines gradually across sets (strong on Sets A & B, moderate on C, weaker on D & E) — typical pattern reflecting average reasoning with more difficulty on higher-difficulty items.

Comments / Clinical Interpretation:
Ayesha’s SPM performance falls in the average range for her age. She demonstrates adequate nonverbal reasoning and abstract problem-solving skills (stronger on simpler items, reduced accuracy on most difficult items). Her cognitive capacity appears intact and sufficient for daily functioning and learning. Emotional distress, anxiety, and attentional difficulty related to ongoing domestic stress may account for reduced performance on the later (more difficult) items. Recommend noting SPM results alongside clinical findings (BDI-II, SAS-15, TIPI) to guide treatment planning; cognitive ability is not a primary barrier to therapy or safety planning.

----------------------------------------------------------------------------------------------------------

---

Abstract

Ayesha, a 28-year-old married woman, presented with anxiety, low self-esteem, and social withdrawal associated with repeated domestic violence and marital distress. Psychological assessment included measures of depression (BDI-II), personality (Ten-Item Personality Inventory), social functioning (Social Adjustment Scale), and cognitive ability (Raven’s Standard Progressive Matrices). Results indicated moderate depression, high neuroticism with low extraversion, significant social maladjustment, and average intellectual functioning. These findings highlight the negative impact of chronic abuse and restricted support on her mental health, personality expression, and social adjustment. Trauma-focused CBT, assertiveness training, and social support mobilization are recommended to enhance resilience, safety, and overall wellbeing.

---

Identifying Information

• Client ID: 2025-002

• Name: A.H

• Age: 28 years

• Gender: Female

• Date of Assessment: May 25, 2025

• Assessor: Muzna Touheed, Psychology Student Intern

• Institution: Govt. Graduate College

---

I. Presenting Problem

Category	Presenting Complaints
Emotional Symptoms	Persistent sadness, shame in disclosing abuse, feelings of helplessness, emotional numbness in conflicts.
Cognitive Symptoms	Preoccupation with violence, difficulty concentrating, self-blame ("I must be a bad wife"), hopeless thinking.
Behavioral Symptoms	Social withdrawal, avoidance of communication, hypervigilance, over-apologizing.
Physiological Symptoms	Headaches, fatigue, muscle tension, sleep disturbances.
Mood Symptoms	Anxiety, irritability, mood swings, loss of interest in daily activities.

---

II. Referral Information

Reason for Referral:
Ayesha was referred following repeated episodes of emotional distress and reported domestic abuse. The purpose was to assess her psychological functioning, emotional state, and coping capacity for therapeutic planning.

---

III. Background Information

• Family History: Father deceased, mother resides in rural Punjab. Has two siblings; sister provides emotional support. No known family psychiatric illness.

• History of Present Illness: Symptoms escalated after frequent marital conflicts. Experiences fear, hopelessness, and self-blame due to abusive environment.

• Academic History: Average student with interest in literature; discontinued further education after marriage.

• Social History: Raised in traditional family; restricted independence after marriage.

• Medical History: History of iron-deficiency anemia; no neurological illness.

---

IV. Behavioral Observations

• Tearful during interview, anxious mood.

• Soft, hesitant speech; low self-confidence.

• No psychotic symptoms observed.

• Insight partial; judgment fair but clouded by emotional distress.

---

V. Psychological Testing

Table 1. Beck Depression Inventory (BDI-II) Results

Score	Severity	Interpretation
28	Moderate Depression	Clinically significant sadness, hopelessness, guilt, and fatigue.

Qualitative Analysis:
Ayesha shows depressive symptoms consistent with her case history of abuse, with sadness, worthlessness, and withdrawal as dominant features.

---

Table 2. Ten-Item Personality Inventory (TIPI) Results

Trait	Score / Trend	Interpretation
Extraversion	Low	Withdrawn, avoids interactions.
Agreeableness	High	Cooperative, submissive, avoids conflict.
Conscientiousness	Average	Maintains responsibility despite stress.
Neuroticism	High	Emotionally unstable, anxious, sensitive.
Openness	Low	Prefers routine, struggles to adapt to change.

Qualitative Analysis:
Her personality reflects submissiveness, conflict-avoidance, and emotional instability, reinforcing vulnerability in abusive relationships.

---

Table 3. Social Adjustment Scale Results

Total Score	Interpretation
37 / 75	Poor–Moderate Social Adjustment

Qualitative Analysis:
Findings show limited confidence in social situations, difficulty in expressing opinions, poor coping with stress, and feelings of social exclusion. This supports her reported social withdrawal and lack of independence.

---

Table 4. Raven’s Standard Progressive Matrices (SPM) Results

Score	Percentile	Interpretation
42 / 60	50th–60th	Average Intellectual Functioning

Qualitative Analysis:
Her cognitive ability is intact. Emotional distress, rather than intellectual weakness, explains her impaired functioning in daily life.

---

VI. Diagnostic Impression

ICD-11 / DSM-5 Formulation:

• F32.1 – Moderate Depressive Episode

• F43.1 – Post-Traumatic Stress Disorder (features: avoidance, hypervigilance, intrusive fears)

• Z63.0 – Relationship Distress with Spouse/Partner

---

VII. Treatment Plan

Goals:

• Reduce anxiety, depression, and self-blame.

• Improve coping skills and resilience.

• Strengthen assertiveness and decision-making.

• Mobilize social and family support for safety.

Interventions:

1. Trauma-focused CBT: Challenging negative beliefs, reframing self-blame.

2. Psychoeducation: Awareness of abuse cycle, normalization of delayed marital milestones.

3. Assertiveness Training: Role-plays, boundary-setting, communication skills.

4. Relaxation & Coping: Breathing, guided imagery, self-care routines.

5. Safety Planning: Emergency contacts, shelter resources, involvement of supportive sister.

Duration: Weekly sessions, 2–3 months.

---

VIII. Conclusion and Recommendations

Ayesha demonstrates average intellectual capacity but significant emotional and social impairment due to ongoing abuse. Moderate depression, high neuroticism, and poor social adjustment highlight her vulnerability. Interventions should focus on trauma recovery, confidence-building, and mobilization of safe support systems.

Recommendations:

• Continued trauma-focused CBT.

• Psychoeducation for Ayesha and her supportive family members.

• Assertiveness and social skills training.

• Connection with women’s protection services if violence persists.

• Regular follow-ups to track mood and safety.

Counseling Sessions

Session 1 – Rapport Building & Psychoeducation
Created a warm and empathetic space to make Ayesha comfortable in expressing her struggles with family conflict and anxiety. Explained the nature of stress and anxiety in simple terms, helping her understand that her reactions are normal. Built initial trust to encourage consistency in therapy.

Session 2 – Emotional Expression & Validation
Encouraged Ayesha to openly share her feelings of being unheard at home. Used active listening and reflection to validate her emotions. Introduced journaling as a tool to release suppressed feelings and recognize emotional triggers.

Session 3 – Cognitive Restructuring (CBT)
Identified Ayesha’s negative thought patterns, such as “I am the cause of family conflict.” Challenged these irrational beliefs through evidence-based questioning. Helped her replace self-blame with more balanced thoughts like “I am doing my best in a difficult situation.”

Session 4 – Problem-Solving & Coping Skills
Worked on practical strategies to handle family disagreements calmly. Practiced communication techniques, such as “I-statements,” to express her needs without escalating conflict. Introduced coping skills like deep breathing and grounding exercises to manage anxiety during stressful interactions.

Session 5 – Self-Empowerment & Future Planning
Focused on building Ayesha’s self-confidence by highlighting her strengths and achievements. Helped her set realistic short-term goals, such as pursuing hobbies or educational interests, to build independence. Developed a long-term resilience plan, emphasizing self-care, support networks, and continued coping strategies.