Psychology Case Study

Psychology Case Study
Task
For this assessment task, write answers to a series of questions relating to a brief case study. The task requires that you interpret and comment on scores obtained on two psychological tests. In this assignment, you will be provided with a written case study (see below) that includes the scores obtained on two psychological tests (the WAIS-III, and the DASS). You will be asked to respond to twelve (12) set questions about the case material. The questions are not of equal value (see Assignment Questions below). Each of the tests used will be covered in lectures and tutorials. Please present your assignment as responses to each individual question, retaining the order as listed. Please note that this assignment is comprised of short-answer questions. Please adhere to the instructions given regarding the length of your answers to the questions. Marks will be deducted for overly long or overly short answers.
Case Study Material
Note – the following material is fictional.
Emma Mitchell, who is 23 years old, presented herself to a University-based psychology clinic complaining of problems with her University studies and marriage. She reported being generally unhappy with her life situation.
A brief clinical interview was conducted, as well as the administration of some standardized psychological tests. The following information was obtained during the brief clinical interview with Emma. No other significant individuals from her life were available to be interviewed. Emma’s childhood was normal with no significant events. However, Emma remembers being described by her mother as a shy, ‘fussy’ child who used to get upset and scared more easily than her two older siblings (a brother and a sister). Emma described her parents as both very loving and caring. Emma described her mother as a ‘worrier’ who was overprotective of the children. Emma reports that her father was often away on business trips and not around very much. However, when he was around he demanded good performance in both academic and social areas. Emma believes that her father has a closer relationship to her other siblings, as she feels that she did not measure up to her father’s expectations and standards. Emma still has a very close relationship with her mother and will often talk to her on the phone on most days. Emma reported that one of her mother’s current concerns is Emma’s health due to her looking very tired and thin.
Emma’s grades during school and high school were reported to be about average. Emma felt that she struggled academically throughout high school, although she performed well enough to secure a place in a BSocSci(Psy)/BTeach(Primary) degree at Charles Sturt University. She is now in her second year and reports feeling ‘just burnt out’ by the end of her first year. She has so far this year failed all but two of her University assignments. Of the two assignments she did pass, she obtained a bare passing grade. She is now wondering whether she has the ability to complete this degree and has requested to be assessed so she can have a better understanding of whether she is ‘intelligent enough’ to undertake such a course. She is considering quitting and starting work fulltime as a salesperson in a large department store in the regional town where she lives. Emma currently does this job in the weekends and during the University semester breaks.
Emma was introduced to her husband shortly after moving from the city to a regional town and they were married after a brief, but intense courtship of 6 months. The intensity of this relationship waned almost immediately after the wedding, and they settled into a routine that is marked neither by contentment nor by obvious problems. Emma seldom fights openly with her husband, but believes that they are increasingly living parallel, but separate lives, where their interactions (including sexual ones) are pleasant but are few and far between.
Other information obtained during the structured interview relates to her fears and to periods of unhappiness. Ever since Emma was a very young child, she has been afraid of snakes and of insects such as spiders. These fears have resurfaced ever since she moved from the city to the regional town about two years ago. Emma also reported she occasionally experienced periods during which she would feel anxious for no particular reason. During these periods she would feel very agitated and would also feel very sad and unhappy. Once at high school, she became so unhappy that she considered suicide. Fortunately, her sister was sensitive to the crisis and took Emma to the school counsellor for help. Emma’s unhappiness did not last long and she ceased seeing the school counsellor after ten sessions.
More recently, Emma has experienced more periods of anxiety and of being unhappy. She believes that her husband is not very interested in hearing about her situation. She has found it difficult making friends since moving from the city and feels that she does not really ‘fit in’ with any particular group of University acquaintances with whom she occasionally socializes. She is worried that she is increasingly spending more and more time on her own but does not know how this can be changed. She reported having difficulties sleeping on most nights and then has difficulties getting out of bed in the mornings. Emma complained that she often experienced headaches and aching muscles which she has put down to being caused by her inability to get enough sleep.
Emma presented as an attractive young woman of a very slender build. She looked tired and had very dark circles around her eyes. She also had a pale or ‘grey’ appearance to her skin. While dressed cleanly and tidily, Emma wore layers of baggy clothes which hid her very slender frame. She was oriented to time and date. Emma was able to maintain effort throughout the two assessment sessions. Breaks were provided during these sessions.
Presented below are data from the two psychological tests that were administered to Emma: the Wechsler Adult Intelligence Scale–Third Edition and the Depression Anxiety Stress Scale.
Results of Psychological Tests
Test 1: Wechsler Adult Intelligence Scale-III (WAIS-III). Emma was administered all 14 subtests on the WAIS-III.
Observations Made During the Administration of the WAIS-III:
• Responses of ‘I don’t know’ were given to many of the later items of the Information and Vocabulary subtests.
• Emma was able to complete correctly four of the items of the Block Design subtest, however, her completion of these items were over the allocated time limit (i.e., no credit could be given).

WAIS-III Profile
The WAIS-III uses raw scores on the 14 subtests to calculate Scaled scores, IQs and Index Scores. It is also possible to identify, in an ipsative manner, subtest strengths and weaknesses. These scores have already been calculated for you and are presented below. Also included below is a brief description of the steps involved in performing these calculations.
Table 1 – Converting Raw Scores to Scaled Scores

Explaining Table 1: Subtest raw scores have been converted to Scaled scores (Mean = 10; SD = 3) using tables in Appendix A of the WAIS-III Administration and Scoring Manual. The sum of scaled scores has then been computed for both the verbal (Verb) and performance (Perf) subtests. As stipulated in the WAIS-III Administration and Scoring Manual, the sum of scaled scores for the verbal subtests does not include Letter-Number Sequencing and the sum of scaled scores for the performance subtests does not include Symbol Search or Object Assembly. The Verbal score and the Performance score have then been combined to give the Full Scale score. Finally the Scaled scores in the last four columns have been used to compute summed scores for: Verbal Comprehension (VC); Perceptual Organization (PO); Working Memory (WM); and Processing Speed (PS).
Table 2 – Determining the IQ and Index Scores
Explaining Table 2: The Verbal score, Performance score and Full Scale score have been converted to their IQ score equivalents (Mean = 100; SD = 15) using tables in Appendix A of the WAIS-III Administration and Scoring Manual. These tables have also been used to determine percentile equivalents and confidence intervals (95%). The sum of scaled scores for VC, PO, WM and PS have been converted to their Index score equivalents (Mean = 100; SD = 15) using tables in Appendix A of the WAIS-III Administration and Scoring Manual. These tables have also been used to determine percentile equivalents and confidence intervals (95%). Qualitative descriptions for the different confidence intervals have also been determined using guidelines from the WAIS-III manual:

Table 3 – Discrepancy Analysis

Explaining Table 3: The discrepancy analysis allows you to determine if there is a significant discrepancy between Verbal and Performance IQ scores and between all of the various combinations of Index scores. Difference scores for the various comparisons are presented in the “Diff” column. The absolute value of the difference score must equal or exceed the “Significance” value to be statistically significant at the .05 level (significance values have been taken from Appendix B of the WAIS-III Administration and Scoring Manual). The last column presents the “Frequency” (cumulative percentages) of the reported difference in the standardization sample. For example Emma has a 8 point difference between her VIQ and PIQ scores. A difference between VIQ and PIQ of 8 points or more was observed in 48% of the standardization sample (the reported frequencies were taken from Appendix B of the WAIS-III Administration and Scoring Manual).
The table below summarises Emma’s mean score on the Verbal subtests, Performance subtests and her overall mean score for all 14 subtests (Full Scale).
Table 4 – Determining Subtest Strengths and Weaknesses

Explaining Table 4: Three means have been calculated: one for all 7 verbal subtests; one for all 7 performance subtests; and an overall mean (Full Scale) for all 14 subtests administered. In each case the mean is simply calculated by adding up all the relevant subtest scaled scores and dividing by the number of subtests.
The table below is used to determine Emma’s strengths and weaknesses. The overall mean (i.e., based on 14 subtests) has been used to calculate the ‘Difference from Mean’ scores.
Table 5 – Difference from the Mean

Explaining Table 5: For each subtest the “Difference from the Mean” has been calculated by subtracting the “Mean Score” from the subtest “Scaled Score”. There are two ways in which this operation can be performed:

• You can use the separate verbal and performance means in which case you would subtract the verbal mean from each of the 7 verbal subtest scaled scores and the performance mean from each of the 7 performance subtest scaled scores.
• Or you can subtract the overall full scale mean from each of the 14 subtest scaled scores.

Please refer to Kaufman & Lichtenberger (1999) (i.e., Reading for Assessment item 2).

Test 2: Depression Anxiety Stress Scale (DASS)
Assignment Questions

WAIS-III Interpretation:
1. Provide a qualitative description for Emma’s Full Scale IQ Score. Should the Full Scale IQ be interpreted as a meaningful representation of Emma’s overall performance? Provide a brief statement supporting your answer
2. For each of the four WAIS-III indices (i.e., VCI, POI, WMI, PSI), identify the key abilities shared by its subtests (starting with those abilities shared by allsubtests of each indice and then those abilities shared by most subtests of each indice)

3. Identify 2 key non-cognitive factors that can influence performance on each of the four WAIS-III indices

4. Identify (and present as dot points) Emma’s relative cognitive strengths. Please note that you will need to examine the key abilities (and influences affecting performance) shared by the subtests that have been identified as Emma’s ‘strengths’

5. Identify (and present as dot points) Emma’s relative cognitive weaknesses. As in Question 4, you will need to examine the key abilities (and influences affecting performance) shared by the subtests that have been identified as Emma’s ‘weaknesses’
Depression, Anxiety Stress Scale (DASS):
6. Provide a brief description (max. 100 words) of Emma’s emotional state and key concerns based on the DASS scores
Integrating the results of the WAIS-III and the DASS:
7. Provide a brief summary (max. 500 words) of what the WAIS-III and the DASS suggest about Emma’s general cognitive ability and emotional state
Inclusion of non-test information in clinical considerations:
8. Identify (and present as dot points) 5 key factors/influences in Emma’s current and past situation that need to be taken into consideration in the interpretation of her WAIS-III and DASS results (5 marks).

9. Identify (and present as dot points) 5 additional sources of information (both test and non-test) that you would obtain to enhance your interpretation of Emma’s test scores. Provide a brief statement explaining each of your choices
Best practice guidelines:
10. Identify (and present as dot points) the most important best practice/ethical considerations that need to be kept in mind during the psychological assessment of Emma (5 marks).

11. Identify (and present as dot points) the most important best practice/ethical considerations that need to be kept in mind when providing feedback to Emma regarding her psychological test results

12. Provide a brief description (max 300 words) of your key recommendations for Emma on the basis of the assessment

Rationale
This assignment is intended to allow you to apply the general knowledge you have gained through the subject content to a specific individual case. The task will require you to make a reasoned, ethical, and integrated interpretation of the test scores provided. You are encouraged to think about the meaning of the scores, how they might relate to each other, and what you would make of them in the context of the other information provided about this individual. Interpretation of psychological test scores is never clear-cut or precise, in that it needs to be done in the context of other client information, including observations made during the testing sessions. All practicing psychologists need to be able to offer justification for any conclusions reached following a psychological assessment. Similarly, you will be expected to be able to offer justification for any interpretations made or conclusions reached. You will also be asked to consider the issues relevant to communicating the outcomes of testing, and the potential impact of psychological testing on an individual client.
Receive feedback on the assignment as a corresponding Grade (see earlier description of the Grading system). Following is a brief general guide on the standard of performance required at each grade.

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