COUC 521 Week 5 Psychological Report Example

Psychological Report: Integrating the IPIP-NEO, a Jungian Type Test and Two Beck Inventories for a Fictional Teacher Referred for Possible Depression

Identifying Information and Referral Question

Name: Megan Ross (fictional). Age: 29. Occupation: second-grade teacher. Referral source: primary care physician. Dates of contact: three sessions over three weeks.

Her physician referred her because tiredness, trouble concentrating and waking too early had lasted four months despite normal blood work. The referral asked two things: whether depression explains the picture, and what would help her keep working.

Assessment Procedures

Initial clinical interview; mental status examination; IPIP-NEO-120 (Johnson, 2014); a free online Jungian type questionnaire, as required by the course; Beck Depression Inventory-II (BDI-II; Beck et al., 1996); and Beck Anxiety Inventory (BAI; Beck & Steer, 1993).

Background and Behavioral Observations

The intake documented low mood, early waking with about five hours of sleep, an eight-pound weight loss, loss of interest in running and social activities, increased sick days and guilt about her teaching, beginning after a heavier class assignment and the move of a close friend. Her maternal family history includes anxiety and a possible depressive episode. On mental status examination, she was oriented and cognitively intact, with slowed speech, constricted affect and self-critical thought content, and she denied suicidal ideation on a structured screen. During testing she worked steadily, asked appropriate clarifying questions and completed all measures in one session; results are considered valid estimates of her current functioning.

Results

Beck Depression Inventory-II

Ms. Ross obtained a total score of 27, which falls in the moderate range according to the manual's guidelines of 0 to 13 minimal, 14 to 19 mild, 20 to 28 moderate and 29 to 63 severe (Beck et al., 1996). Her highest item ratings concerned loss of pleasure, guilty feelings, self-criticism, loss of energy, changes in sleeping pattern and concentration difficulty. She rated the item on suicidal thoughts at 0. The pattern matches what she reported at intake and what was observed in the mental status examination. The BDI-II's 21 items ask about the past two weeks and follow the symptom criteria for depression, which makes it suitable both for answering the referral question and for tracking change once counseling begins.

Beck Anxiety Inventory

Her BAI total of 13 falls in the mild range of 8 to 15 (Beck & Steer, 1993). Her endorsed items were mostly cognitive, such as fear of the worst happening and inability to relax, rather than physical symptoms of panic. Anxiety therefore appears to accompany her low mood rather than drive it. Because the BAI emphasizes physical symptoms, a mild score in a client whose worry is largely cognitive should not be read as the absence of anxiety, and her worry about work deserves attention in counseling.

IPIP-NEO-120

The IPIP-NEO-120 measures the five broad traits and their 30 facets without licensing fees (Johnson, 2014), drawing its items from a public item pool built for open research (Goldberg et al., 2006). Ms. Ross scored high in neuroticism, especially on the facets of depression, anxiety and self-consciousness, which describes a tendency to experience negative emotions intensely and to be self-critical. She scored low in extraversion, particularly on gregariousness and activity level, and high in conscientiousness, with elevated achievement striving and dutifulness. High agreeableness, including altruism, fits her history as "the one people come to." Personality traits are stable tendencies rather than symptoms, but this profile suggests a person who holds very high standards, puts others first and is vulnerable to self-blame when demands exceed her capacity. The combination of high conscientiousness and high neuroticism may also explain why she kept working at full effort for months before seeking help: she is likely to interpret struggling as failure. Her average openness suggests she may be willing to try new coping strategies if they are presented as practical rather than abstract.

Jungian Type Questionnaire

The online questionnaire classified her as ISFJ, a type described as introverted, sensing, feeling and judging. The description of a quiet, responsible and caring person resonated with Ms. Ross. Type measures based on Jung's theory, however, have significant psychometric limitations, including questions about the stability of type assignments and the validity of sorting people into categories (Pittenger, 2005). The result was used only to start a conversation about how she prefers to recharge, not to support any clinical conclusion. She found it useful to notice that her preference for quiet, one-on-one time is not a flaw, which may help her plan restorative evenings without guilt.

Cultural and Ethical Considerations

Several factors shape how these results should be read. The IPIP-NEO percentiles compare Ms. Ross with large samples of online volunteers rather than a clinical population, so they describe her relative to other adults, not to other clients. Her rural upbringing valued self-reliance, and her faith led her to wonder whether low mood reflected weak trust in God; both may affect how she responds to items about guilt and help-seeking, and both are discussed with her rather than treated as symptoms. She gave informed consent for testing, was told how the results would be used and shared, and received feedback on her scores in plain language during the third session, when she said that seeing the numbers made her feel "less crazy and more like this is a real thing."

Summary and Diagnostic Impression

The measures converge: a moderate BDI-II score, mild anxiety, and interview and observation findings all point to a depressive episode that emerged under increased workload and social loss in a conscientious, self-critical person. Her normal laboratory results, intact cognition and the timing of symptom onset make a primary medical or cognitive explanation less likely, although that judgment remains her physician's. Asked about past highs, she described no stretch of time with racing energy, reduced sleep without fatigue or risky decisions, which makes a bipolar presentation unlikely, and her limited alcohol use does not appear to explain her symptoms. The presentation is consistent with a provisional impression of major depressive disorder, single episode, moderate (American Psychiatric Association, 2022), pending confirmation through continued clinical contact. No current suicide risk was identified.

In answer to the referral question, her symptoms are consistent with depression rather than an unexplained medical problem, and treatment of the depression is likely to improve her functioning at work. Her strengths, including commitment to her students, close ties with her sister, a supportive church and a history of benefiting from counseling in college, give a favorable outlook.

Recommendations

• 1. Begin individual counseling weekly, with an evidence-based approach for depression such as cognitive behavioral therapy or behavioral activation, including work on self-critical thinking and reengaging in running and friendships. Early sessions should set small, scheduled activity goals, since her conscientiousness suggests she will follow a plan once it is concrete.
• 2. Repeat the BDI-II every four weeks to monitor progress, and rescreen for suicidal ideation at each session.
• 3. Share these results with her physician, with her consent, so that the physician can consider whether a medication evaluation is appropriate.
• 4. Address workload directly: help Ms. Ross prepare to ask her principal and the school's behavior specialist for support with her class, and consider whether a short medical leave would be helpful if symptoms worsen.
• 5. Target sleep with a consistent schedule, reduced afternoon caffeine and a wind-down routine, and refer to her physician if early waking persists after four weeks of treatment.
• 6. Explore her faith as a resource, including her concern about "not trusting God enough," in a way that respects her beliefs.
• 7. Reassess in three months, including a repeat of the IPIP-NEO only if personality questions become clinically relevant.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory manual. Psychological Corporation.

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. Psychological Corporation.

Goldberg, L. R., Johnson, J. A., Eber, H. W., Hogan, R., Ashton, M. C., Cloninger, C. R., & Gough, H. G. (2006). The International Personality Item Pool and the future of public-domain personality measures. Journal of Research in Personality, 40(1), 84-96. https://doi.org/10.1016/j.jrp.2005.08.007

Johnson, J. A. (2014). Measuring thirty facets of the Five Factor Model with a 120-item public domain inventory: Development of the IPIP-NEO-120. Journal of Research in Personality, 51, 78-89. https://doi.org/10.1016/j.jrp.2014.05.003

Pittenger, D. J. (2005). Cautionary comments regarding the Myers-Briggs Type Indicator. Consulting Psychology Journal: Practice and Research, 57(3), 210-221. https://doi.org/10.1037/1065-9293.57.3.210