1

ABNORMAL PSYCHOLOGY

Cognition: Case Report

By Jinal M Velani

III Bsc Psychology

SRN No. PES1UG23PY075

Guide : Dr.LIKITHA.S

Department of Psychology

PES University

Bangalore

13/03/2025
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Introduction to the Beck Depression Inventory (BDI-II)

The Beck Depression Inventory (BDI-II) is one of the most widely used self-report inventories

for assessing the severity of depressive symptoms in individuals. It was originally developed

by Dr. Aaron T. Beck in 1961 based on his cognitive theory of depression, which emphasizes

the role of negative thought patterns and cognitive distortions in the development and

persistence of depression (Beck et al., 1961).

Over time, the BDI has undergone multiple revisions to reflect advances in depression research

and diagnostic criteria. The most recent version, BDI-II (1996), was updated to align with

DSM-IV and later DSM-5 criteria for Major Depressive Disorder (MDD) (Beck, Steer, &

Brown, 1996). This revision made the scale more relevant in modern clinical practice,

improving its ability to assess both emotional and physical symptoms of depression.

Due to its strong psychometric properties, ease of use, and broad applicability, the BDI-II is

widely used in clinical settings, mental health research, educational institutions, and

occupational health programs. This introduction provides a detailed overview of its

development, structure, psychometric properties, applications, and overall significance in

depression assessment.

Development

The original BDI (1961) was created as a clinical rating scale to assess the presence and severity

of depression. It was designed based on observed symptoms in patients with depression, which

were categorized into cognitive, affective, and somatic dimensions (Beck et al., 1961).

Over time, revisions were made to improve its accuracy:

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• BDI-IA (1978): Adjusted item wording for better readability and minor improvements

in scoring.

• BDI-II (1996): Major revision to reflect modern diagnostic criteria (DSM-IV, later

DSM-5), incorporating new symptoms such as agitation and worthlessness while

removing outdated items like body image distortion.

The BDI-II is now considered one of the most effective tools for detecting and evaluating

depression severity in both clinical and non-clinical populations.

Structure of the BDI-II

The BDI-II consists of 21 items, each assessing a different symptom of depression. These items

cover a broad range of emotional, cognitive, behavioral, and physiological symptoms, making

it a comprehensive measure of depression severity.

Each item is rated on a scale of 0 to 3, with higher scores indicating greater symptom severity.

Respondents are asked to reflect on their experiences over the past two weeks, ensuring that

the assessment captures both short-term distress and chronic depressive symptoms.

Key Components of the BDI-II

The 21 items are categorized into four major symptom dimensions:

1. Emotional Symptoms

a. Sadness: Ranges from no sadness (0) to extreme sadness that is unbearable (3).

b. Loss of pleasure (Anhedonia): Inability to enjoy activities once found

pleasurable.
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c. Feelings of worthlessness and guilt: Self-blame, excessive guilt, or feeling like

a burden.

2. Cognitive Symptoms

a. Pessimism: Negative thoughts about the future.

b. Self-dislike and self-criticism: Harsh self-judgment and disappointment in

oneself.

c. Suicidal thoughts: Ranges from no suicidal thoughts (0) to clear suicidal intent

(3).

3. Behavioral and Somatic Symptoms

a. Loss of energy and fatigue: Feeling drained and exhausted.

b. Sleep disturbances: Insomnia or excessive sleep.

c. Changes in appetite: Either excessive eating or loss of appetite.

4. Interpersonal and Social Symptoms

a. Irritability: Increased frustration and agitation.

b. Indecisiveness: Difficulty making decisions.

c. Loss of interest in relationships and social interactions.

Scoring System

The total score is calculated by summing responses across all 21 items, resulting in a score

ranging from 0 to 63. The severity of depression is classified into four levels:

Score Range Interpretation

0–13 Minimal depression

14–19 Mild depression

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20–28 Moderate depression

29–63 Severe depression (clinical intervention recommended)

This scoring system enables clinicians, researchers, and therapists to determine whether an

individual is experiencing temporary distress or clinical depression, guiding appropriate

intervention strategies.

Psychometric Properties of the BDI-II

The BDI-II is recognized for its strong psychometric properties, making it one of the most

reliable and valid tools for depression assessment.

Reliability

• High internal consistency (Cronbach’s alpha = 0.92), meaning items within the

questionnaire are highly correlated.

• High test-retest reliability (r = 0.93), meaning that results remain stable when reassessed

over time.

Validity

• The BDI-II strongly correlates with other depression scales such as:

o Hamilton Depression Rating Scale (HDRS)

o Patient Health Questionnaire (PHQ-9)

• Shows strong construct validity, meaning it effectively differentiates between

depressed and non-depressed individuals.

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Norms and Cultural Adaptations

• The BDI-II has been standardized across various populations, including adolescents,

adults, and elderly individuals.

• It has been translated into multiple languages and validated in different cultures (Byrne

et al., 2007), ensuring cross-cultural applicability.

Applications of the BDI-II

1. Clinical Use

• Used for screening and diagnosing depression in psychiatric and general healthcare

settings.

• Guides treatment decisions by identifying symptom severity.

2. Research and Epidemiological Studies

• Frequently used in large-scale studies to measure depression prevalence.

• Helps researchers examine risk factors, gender differences, and social determinants of

depression.

3. Educational and Occupational Settings

• Applied in school counseling centers and workplace mental health programs.

• Helps detect burnout and emotional distress in students and employees.

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4. Forensic and Legal Evaluations

• Used in legal cases involving mental health evaluations, disability claims, and

competency assessments.

Strengths and Limitations

Strengths

• Easy to administer and score.

• Strong reliability and validity.

• Applicable in clinical and non-clinical settings.

Limitations

• Self-report format may lead to social desirability bias.

• Does not differentiate depression from anxiety disorders.

• May require clinical follow-up for deeper diagnosis.

Conclusion

The Beck Depression Inventory-II (BDI-II) is a highly reliable and valid tool for assessing the

severity of depressive symptoms. Its structured format, strong psychometric properties, and

broad applications make it an essential instrument in clinical diagnosis, treatment planning,

and research. As depression awareness continues to grow, the BDI-II remains a cornerstone of

depression assessment, guiding mental health professionals in identifying, monitoring, and

treating depression to improve overall well-being.

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Introduction to the Mental Status Examination (MSE)

The Mental Status Examination (MSE) is a key component of psychiatric assessment used to

evaluate an individual’s cognitive, emotional, and behavioral state at a given point in time. It

provides a systematic method for assessing a patient’s thought processes, emotional stability,

perception, and overall mental functioning. The MSE is an essential part of clinical practice,

helping in diagnosis, treatment planning, and progress monitoring.

The MSE is conducted through direct observation and structured questioning, allowing mental

health professionals to assess a wide range of psychological functions. It is particularly useful

in differentiating between psychiatric disorders, neurological impairments, and temporary

emotional distress.

This study explores the significance of the Mental Status Examination (MSE) in clinical

practice, focusing on its development, structure, psychometric properties, applications, and

overall importance in mental health assessment.

Development and Structure of the MSE

The Mental Status Examination (MSE) has evolved as a structured and standardized tool for

evaluating mental and cognitive functions. Initially based on informal observations, it has been

refined into a comprehensive and systematic framework that ensures consistency in mental

health assessments across various clinical settings.

Structure of the MSE:

The MSE consists of several key domains, each focusing on a specific aspect of mental health.

Together, they offer a holistic understanding of an individual’s psychological well-being.

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1. Appearance:

a. Observations about physical presentation, grooming, posture, and attire.

b. Helps in identifying neglect, self-care issues, or signs of psychiatric conditions

such as depression or mania.

2. Behavior:

a. Evaluates body movements, gestures, eye contact, and psychomotor activity.

b. Abnormal behaviors (e.g., agitation, restlessness, repetitive movements) can

indicate underlying psychiatric disorders.

3. Mood and Affect:

a. Mood: The patient’s subjective emotional state (e.g., happy, sad, anxious).

b. Affect: The observable emotional expression, including its range,

appropriateness, and variability.

c. Helps identify conditions such as depression (flat affect), mania (expansive

affect), or schizophrenia (inappropriate affect).

4. Speech:

a. Assesses rate, volume, fluency, and coherence of speech.

b. Abnormalities (e.g., pressured speech in mania, slowed speech in depression, or

disorganized speech in psychosis) provide diagnostic insights.

5. Thought Process:

a. Examines the organization and flow of thoughts.

b. Logical and goal-directed thinking is considered normal, while tangentiality,

flight of ideas, or thought blocking may indicate disorders like schizophrenia or

bipolar disorder.

6. Thought Content:

a. Focuses on delusions, obsessions, phobias, suicidal ideation, and hallucinations.

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b. Identifies psychotic symptoms, compulsive thoughts, or self-harm risks.

7. Cognition:

a. Includes orientation to time, place, and person, memory, attention span, and

problem-solving abilities.

b. Formal cognitive tests such as the Mini-Mental State Examination (MMSE) or

Montreal Cognitive Assessment (MoCA) are often used.

8. Judgment and Insight:

a. Judgment: The patient’s ability to make reasonable decisions based on reality.

b. Insight: The patient’s understanding of their own mental health condition.

c. Impaired judgment and poor insight are common in psychotic disorders,

substance abuse, and severe mood disorders.

The structured nature of the MSE ensures comprehensive and consistent documentation,

helping clinicians develop accurate psychiatric diagnoses and treatment plans.

Psychometric Properties of the MSE

For any clinical assessment to be effective, it must have strong psychometric properties,

ensuring its accuracy and usefulness in psychiatric evaluations.

• Reliability: The MSE has high inter-rater reliability, meaning that different clinicians

assessing the same patient typically reach similar conclusions.

• Validity: The MSE aligns with standardized diagnostic criteria such as the DSM-5

(Diagnostic and Statistical Manual of Mental Disorders) and ICD-11 (International

Classification of Diseases), making it a valid tool for mental health assessment.

To enhance accuracy, clinicians often use structured cognitive tests, such as:
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• Mini-Mental State Examination (MMSE) – Screens for cognitive impairment in

conditions like dementia.

• Montreal Cognitive Assessment (MoCA) – Identifies mild cognitive impairment (MCI).

• SLUMS (Saint Louis University Mental Status Exam) – Assesses early cognitive

decline.

These tests complement the MSE, improving its ability to detect subtle cognitive and

psychiatric changes.

Applications of the MSE

The MSE is widely used in different areas of mental health and clinical practice:

1. Psychiatric Diagnosis

• Helps diagnose disorders such as depression, schizophrenia, bipolar disorder, and

anxiety disorders.

• Assesses psychotic symptoms, mood disturbances, cognitive deficits, and behavioral

abnormalities.

2. Neurological and Cognitive Assessment

• Detects early signs of dementia, delirium, and traumatic brain injuries.

• Differentiates psychiatric conditions from neurological disorders.

3. Legal and Forensic Evaluations

• Used in competency assessments for guardianship, legal trials, and criminal cases.
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• Helps determine fitness to stand trial and assess psychiatric conditions in forensic

settings.

4. Treatment Planning and Monitoring

• Guides treatment decisions, ensuring patients receive appropriate interventions.

• Helps track treatment progress, including medication effects and psychotherapy

outcomes.

5. Emergency and Crisis Interventions

• Assists in evaluating suicidal risks, aggression, and psychotic episodes in emergency

settings.

• Helps in deciding on psychiatric hospitalization or crisis management strategies.

The MSE is a versatile tool that can be adapted to outpatient clinics, psychiatric hospitals,

emergency rooms, and rehabilitation centers.

5. Conclusion

The Mental Status Examination (MSE) is an indispensable tool in psychiatric and clinical

psychology, providing a systematic and objective assessment of an individual’s mental,

emotional, and cognitive state. By evaluating appearance, thought processes, cognition, and

behavior, the MSE plays a crucial role in diagnosing mental disorders, guiding treatment plans,

and monitoring patient progress.

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Its structured nature, reliability, and broad clinical applications make it a cornerstone of

psychiatric practice. As mental health care continues to evolve, the MSE remains an essential

method for understanding and addressing psychiatric conditions, ensuring that individuals

receive the necessary support and treatment for their well-being.

Introduction to the Kuppuswamy Scale (2024)

The Kuppuswamy Scale is a widely used tool for assessing socioeconomic status (SES) in India,

particularly in research, public health, and social sciences. Developed by Dr. R. Kuppuswamy

in 1976, the scale has undergone multiple revisions to reflect India's evolving economic

landscape, with the latest update in 2024 enhancing its accuracy in analyzing SES-related

health and social outcomes.

Historical Context and Structure

Originally designed to study the impact of SES on mental health, the scale classifies individuals

based on three key components:

1. Education – Measures the educational attainment of the household head.

2. Occupation – Categorizes jobs based on prestige and stability.

3. Income – Evaluates monthly household income, adjusted for inflation.

These parameters are scored to classify SES into lower, middle, and upper categories, aiding

in targeted interventions and research.

Significance and Applications

The 2024 update refines income brackets and scoring criteria, ensuring relevance to modern

socioeconomic realities. The scale is instrumental in:

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• Public Health: Identifying SES-related health disparities and guiding healthcare

policies.

• Education: Addressing barriers to learning for lower-SES students and informing

scholarships.

• Research & Policy: Analyzing SES influences on mental health, social behavior, and

economic mobility.

Reliability, Limitations, and Future Directions

The Kuppuswamy Scale remains valid and reliable, widely used in SES studies. However, it

lacks qualitative dimensions like social capital and digital access, which future updates could

incorporate to enhance its comprehensiveness.

Conclusion

The 2024 Kuppuswamy Scale continues to be a critical tool for SES assessment, influencing

health, education, and social policies in India. By adapting to socioeconomic changes, it

ensures accurate classification and supports data-driven interventions aimed at reducing

disparities and promoting social equity.

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CASE PRESENTATION 1

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : DJV PLACE :BANGALORE

AGE : 36 YEARS

GENDER : FEMALE

Socio-Demographic Details

The participant, DJV, is a 36-year-old female who follows the Hindu religion. She has

completed her education up to a bachelor's degree and is married. She is a homemaker,

managing household responsibilities. The family consists of eleven members, with three

dependents, indicating a large household size. Despite their middle-class status, they own

their home, reflecting financial stability and security. The participant has health insurance,

which provides financial support in times of medical need. However, she does not engage in

regular physical activity, which may impact overall well-being. Gujarati is the primary

language spoken at home, preserving her cultural heritage. The participant is a citizen of

India.

The assessment took place in a well-lit and quiet room to ensure a comfortable environment.

Rapport was established to create a supportive and non-threatening setting. The assessment

aimed to provide insights into the participant’s emotional and psychological well-being,

contributing to mental health awareness and future treatment planning. Participation in the

assessment was voluntary, with the right to withdraw at any time without penalty. The

participant was informed that there were no physical risks associated with participation and

was encouraged to seek clarification if needed.

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Case Analysis of BDI-II

Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to evaluate the participant’s

level of depression. The necessary instructions were provided before the assessment:

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. Circle the number beside the chosen statement. If multiple statements

apply, select the highest number in that group. Ensure that only one statement is chosen for

each group, including Item 16 (Changes in Sleeping Pattern) and Item 18 (Changes in

Appetite)."

The participant completed the assessment under standardized conditions to ensure accuracy

and reliability in responses.

Interpretation

The participant obtained a BDI-II score of 12, which falls within the Minimal Depression range.

This suggests that while the participant experiences some depressive symptoms, they are not

severe enough to indicate clinical depression. However, these symptoms may still have a minor

impact on daily life and emotional well-being.

The participant reported experiencing occasional sadness and mild reduction in pleasure from

activities, which are common indicators of low mood. Additionally, mild fatigue and

occasional feelings of restlessness suggest slight emotional distress. However, the absence of

significant changes in sleep or appetite, lack of feelings of worthlessness, and intact

concentration abilities indicate that these symptoms do not severely disrupt daily
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functioning.Key responses from the assessment include occasional sadness, mild reduction in

pleasure from activities, and slight fatigue. The participant reported not crying more than usual,

indicating stability in emotional expression. There were no significant changes in sleep or

appetite patterns, and no feelings of worthlessness or difficulty in concentration. These findings

suggest that the participant may occasionally experience mood fluctuations but does not exhibit

persistent or overwhelming depressive symptoms.

Conclusion

Although the participant's depressive symptoms are minimal, incorporating self-care strategies,

social engagement, and healthy routines may help maintain emotional well-being. Since there

is no indication of severe distress, professional intervention is not immediately required.

However, if symptoms increase in frequency or intensity, further psychological assessment and

support may be beneficial.

TABLE 1: Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

DJV 36 12 Minimal Depression

Case Analysis of MSE

The Mental Status Examination (MSE) was conducted to assess the participant's current

psychological functioning across multiple domains. The findings are as follows:

• Appearance: The participant was neatly groomed, with no signs of dishevelment or

inappropriate attire, indicating intact self-care and personal hygiene.

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• Speech: Speech was normal in rate, tone, and volume, with no evidence of tangentiality,

pressured speech, or impoverishment. This suggests coherent and goal-directed verbal

communication.

• Eye Contact: The participant maintained normal eye contact, implying comfort in social

interactions and an absence of significant social withdrawal or avoidance.

• Motor Activity: The participant's motor behaviour was normal, with no signs of

psychomotor agitation, retardation, or involuntary movements.

• Affect: Affect was observed to be full, indicating a broad range of emotional expression,

which aligns with the context of the interview.

• Mood: The participant reported feeling anxious and irritable, suggesting underlying

emotional distress or reactivity. The presence of irritability may indicate frustration or

heightened sensitivity to external stimuli.

• Cognition: Orientation was intact, with no impairments in person, place, time, or object

recognition. Memory function was also intact, with no indications of short-term or long-

term memory deficits. Attention span was normal, reflecting the ability to concentrate

and engage with the evaluation process.

• Perception: There were no hallucinations or perceptual disturbances, and the participant

did not report experiences of derealization or depersonalization.

• Thought Content and Process: There were no signs of suicidal or homicidal ideation,

intent, or plans. Additionally, there were no delusions, and thought processes appeared

logical and coherent.

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• Behaviour: The participant was cooperative throughout the evaluation but also

exhibited agitation, suggesting possible restlessness, frustration, or heightened

emotional reactivity.

• Insight: Insight was good, indicating an understanding of personal psychological

experiences and the need for self-awareness or intervention if necessary.

• Judgment: The participant's judgment was good, suggesting the ability to make sound

decisions and respond appropriately to situations.

Conclusion

The participant presents with a generally intact mental status, with preserved cognition,

perception, and thought processes. However, the presence of anxiety, irritability, and agitation

may suggest underlying emotional distress or situational stressors. The absence of suicidality,

homicidal, or delusions is reassuring, and good insight and judgment indicate that the

participant is capable of understanding their emotional state and making informed decisions.

Given the emotional symptoms observed, further evaluation of potential stressors, anxiety-

related conditions, or mood instability may be warranted.

Introspection Report: I felt at ease, just taking things one step at a time. It wasn't particularly

exciting or difficult, just a small part of my day that I moved through without much thought.

Observation Report: The participant sat comfortably, maintaining a relaxed posture throughout

the session. They appeared focused, occasionally adjusting their glasses while reading the

questions carefully before responding.

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CASE PRESENTATION 2

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : AK PLACE :BANGALORE

AGE : 45 YEARS

GENDER : FEMALE

Socio-Demographic Details

The participant, AK, is a 45-year-old female who follows the Hindu religion. She has

completed her education up to a bachelor's degree and is married. She is employed as a

teacher, actively engaged in a professional role. The family consists of four members, with

three dependents, indicating a moderately sized household. The participant belongs to the

lower middle class socioeconomic status and owns a home, suggesting financial stability

despite economic limitations.

The participant has health insurance, ensuring access to medical care when needed.

Additionally, she engages in regular physical activity, which is beneficial for maintaining

overall well-being. Kannada is the primary language spoken at home, reinforcing her cultural

and linguistic roots. The participant is a citizen of India.

The assessment was conducted in a well-lit and quiet room, ensuring comfort and focus.

Rapport was established to foster a supportive and non-threatening environment. The goal of

the assessment was to gain insight into the participant’s emotional and psychological well-

being, contributing to mental health awareness and potential treatment recommendations.

Participation was voluntary, with the right to withdraw at any time without penalty. The

participant was informed of the confidentiality of the assessment and encouraged to seek

clarification if needed.
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Case Analysis of BDI-II

Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to evaluate the participant’s

level of depression. The necessary instructions were provided before the assessment:

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. Circle the number beside the chosen statement. If multiple statements

apply, select the highest number in that group. Ensure that only one statement is chosen for

each group, including Item 16 (Changes in Sleeping Pattern) and Item 18 (Changes in

Appetite)."

The participant completed the assessment under standardized conditions to ensure the accuracy

and reliability of responses.

Interpretation of Results

The participant obtained a BDI-II score of 5, which falls within the Minimal or No

Depression range. This indicates an absence of clinically significant depressive symptoms,

suggesting that the participant currently maintains good emotional stability and functional

well-being.

A score within this range suggests that the participant does not experience persistent negative

emotions or disruptions in cognitive, emotional, or behavioral functioning. AK’s responses

indicate a generally positive mood, adequate energy levels, and no significant disturbances in
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sleep, appetite, or concentration. These findings suggest resilience and adaptive coping

mechanisms that contribute to emotional regulation and stability.

From a psychological perspective, individuals with minimal or no depressive symptoms

typically exhibit effective coping skills, balanced social interactions, and adequate emotional

regulation strategies. Given the participant's professional engagement as a teacher, structured

routines, social engagement, and intellectual stimulation may play a role in maintaining

positive mental health. Additionally, regular physical activity has been shown to contribute to

mental well-being by reducing stress and enhancing mood.

Conclusion

Based on the assessment, AK does not exhibit significant depressive symptoms. The participant

demonstrates emotional resilience and stable psychological functioning. However, mental

health is dynamic, and preventive measures such as stress management, continued physical

activity, and social engagement are recommended to sustain well-being. If distressing

symptoms emerge in the future, periodic psychological check-ins or self-reflective practices

may be beneficial.

Overall, the participant’s assessment results reflect a balanced emotional state with no

immediate need for intervention.

TABLE 2: Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

AK 45 5 Minimal Depression
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Case Analysis of MSE

The Mental Status Examination (MSE) was conducted to assess the participant's current

psychological state across multiple domains. The findings are as follows:

• Appearance: The participant was neatly groomed, indicating adequate self-care and no

signs of neglect in personal hygiene.

• Speech: Speech was normal in rate, tone, and volume, suggesting coherent and goal-

directed communication. There were no indications of tangentiality, pressured speech,

or speech impoverishment.

• Eye Contact: The participant maintained normal eye contact, implying comfort in social

interactions without excessive avoidance or intensity.

• Motor Activity: Motor behaviour was normal, with no signs of psychomotor agitation,

retardation, or involuntary movements.

• Affect: Affect was observed to be full, meaning the participant displayed a broad range

of emotional expressions that appeared appropriate to the context.

• Mood: The participant reported feeling irritable, which may indicate emotional distress,

frustration, or sensitivity to external stimuli. Irritability can be associated with stress,

mood instability, or difficulty regulating emotions.

• Cognition: Orientation was intact, with no impairments in awareness of person, place,

time, or objects. Memory function was intact, with no signs of short-term or long-term

memory deficits. Attention was normal, indicating the ability to concentrate and engage

effectively during the assessment.

• Perception: No hallucinations or perceptual disturbances were reported, and there were

no experiences of derealization or depersonalization.

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• Thought Content and Process: There were no signs of suicidal or homicidal ideation,

intent, or plans. Additionally, no delusions were present, and thought processes were

logical and coherent.

• Behaviour: The participant was cooperative during the examination but also displayed

guarded and agitated behaviour. Guardedness may indicate reluctance to disclose

personal information, suspicion, or a defensive stance, while agitation suggests

restlessness, frustration, or heightened emotional sensitivity.

• Insight: Insight was good, meaning the participant demonstrated an understanding of

their emotional state and psychological processes.

• Judgment: Judgment was good, reflecting the ability to make sound decisions and

respond appropriately to various situations.

Conclusion

The participant's mental status examination indicates a generally intact cognitive and

perceptual state, with preserved insight, judgment, and logical thought processes. However, the

presence of irritability, guarded behaviour, and agitation may suggest underlying stress,

emotional distress, or mood-related difficulties. The guarded nature of responses could indicate

reluctance to engage fully in the assessment, possibly due to trust issues, discomfort, or

perceived vulnerability. Agitation may reflect heightened emotional reactivity, frustration, or

anxiety.

While no immediate risk factors (such as suicidality, homicidally, or delusions) are present, the

observed emotional symptoms warrant further exploration into potential stressors, mood

dysregulation, or anxiety-related concerns. If these symptoms persist or intensify, additional

psychological assessment and intervention may be beneficial.

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Introspection Report: There wasn't much to think deeply about—I just did what was needed

and kept going. It was a simple, straightforward process, nothing too complicated.

Observation Report: The participant displayed a calm demeanour, speaking in a measured tone

with clear articulation. They occasionally paused to reflect on their answers, suggesting a

thoughtful and deliberate approach.

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CASE PRESENTATION 3

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : BMV PLACE :BANGALORE

AGE : 37 YEARS

GENDER : MALE

Socio-Demographic Details

The participant, BMV, is a 37-year-old male who follows the Hindu religion. He is married

and has completed his education up to a bachelor's degree. He is self-employed as a

businessman. The participant resides in a rented home with a total household size of six

members, including four dependents. His middle-class socioeconomic status suggests

financial stability, though managing a household of this size may contribute to various

stressors.

The participant has health insurance, ensuring access to medical care when needed. However,

he does not engage in regular physical activity, which can influence overall physical and mental

well-being. Gujarati is the primary language spoken at home, maintaining cultural identity. He

is a citizen of India.

The assessment was conducted in a structured and comfortable environment to ensure accuracy

and reliability in responses. Rapport was established to foster a supportive and non-threatening

setting, encouraging honest participation. The participant was informed that the assessment

was voluntary, confidential, and posed no physical risks.

 27

Case Analysis of BDI-II

Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to evaluate the participant’s

level of depression. The necessary instructions were provided before the assessment:

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. Circle the number beside the chosen statement. If multiple statements

apply, select the highest number in that group. Ensure that only one statement is chosen for

each group, including Item 16 (Changes in Sleeping Pattern) and Item 18 (Changes in

Appetite)."

The participant completed the assessment under standardized conditions to ensure response

accuracy and reliability.

Interpretation of Results

BMV obtained a BDI-II score of 1, which falls within the Minimal or No Depression range.

This indicates that the participant does not exhibit symptoms of clinical depression, and his

emotional well-being appears stable.

The participant reported no significant mood disturbances, negative thoughts, or cognitive

difficulties. His responses indicate a positive mental state, stable energy levels, and no

disruptions in sleep or appetite patterns. He does not experience persistent sadness, loss of

pleasure, or fatigue, which are hallmark symptoms of depression.

Given the absence of depressive symptoms, BMV demonstrates good emotional resilience.

However, factors such as stress from managing a business, financial responsibilities, or lack of

physical activity could still influence mental well-being over time. Maintaining a balanced
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lifestyle, social engagement, and stress management techniques can help sustain emotional

stability. Regular self-reflection and awareness of mood changes may further support long-

term well-being.

Conclusion

The participant does not show any signs of clinical depression and appears to have stable

emotional well-being. While no immediate intervention is necessary, maintaining a healthy

work-life balance, stress management, and physical activity can contribute to long-term

mental health. If any emotional distress arises in the future, seeking professional support may

be beneficial.

TABLE 3: Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

BMV 37 1 Minimal Depression

Case Analysis of MSE

A Mental Status Examination (MSE) was conducted to evaluate the participant's current

psychological state. The findings are as follows:

• Appearance: The participant was neatly groomed, indicating adequate self-care and

attention to personal hygiene.

• Speech: Speech was normal in rate, tone, and volume, suggesting coherent and goal-

directed communication. There were no signs of speech abnormalities such as pressured,

tangential, or impoverished speech.

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• Eye Contact: The participant exhibited avoidant eye contact, which may indicate

discomfort, anxiety, social withdrawal, or an attempt to evade engagement in the

interaction. Avoidant eye contact is often observed in individuals experiencing social

anxiety, emotional distress, or difficulties with trust.

• Motor Activity: The participant displayed restless motor activity, suggesting physical

agitation or internal distress. Restlessness can be associated with anxiety, heightened

emotional arousal, or difficulty regulating stress responses.

• Affect: Affect was noted to be full, meaning the participant demonstrated a broad range

of emotional expressions that were appropriate to the context of the interaction.

• Mood: The participant reported feeling anxious, angry, and irritable, indicating a state

of heightened emotional distress. Anxiety may contribute to restlessness and avoidant

behaviour, while anger and irritability suggest possible frustration, emotional

dysregulation, or sensitivity to perceived stressors.

• Cognition: The participant was fully oriented to person, place, time, and objects, with

no memory impairments observed. However, attention was noted to be distracted,

indicating difficulty maintaining focus, which may be linked to anxiety, emotional

distress, or cognitive overload.

• Perception: There were no hallucinations or perceptual distortions, and the participant

did not report derealization or depersonalization experiences.

• Thought Content and Process: No suicidal or homicidal ideation, intent, or plans were

reported. Additionally, no delusions were present, and the participant's thought

processes appeared logical and organized.

 30

• Behaviour: The participant was cooperative but also exhibited aggressive and agitated

behaviour. The presence of aggression and agitation alongside restlessness and mood

disturbances suggests a heightened emotional state that may be linked to underlying

frustration, distress, or difficulty managing emotions.

• Insight: Insight was good, indicating that the participant demonstrated an awareness of

their emotional state and mental health.

• Judgment: Judgment was good, suggesting that the participant is capable of making

sound decisions and responding appropriately to various situations.

Conclusion

The participant's cognitive and perceptual functions are intact, with good insight and judgment,

but the presence of anxiety, anger, irritability, restlessness, and agitation suggests significant

emotional distress. The avoidant eye contact, distracted attention, and restless motor activity

point to underlying tension, anxiety, or difficulty managing internal emotional states.

The combination of agitation, aggression, and emotional instability raises concerns about

impulse control and emotional regulation, which may require further psychological assessment

to determine if these symptoms stem from anxiety-related disorders, mood disturbances, or

situational stressors. Given the absence of suicidal/homicidal ideation, immediate risk is low;

however, continued monitoring and therapeutic intervention may be beneficial to help the

participant develop coping strategies for emotional regulation.

Introspection Report: I went through everything at a normal pace, not feeling rushed or

pressured. It felt like any other quiet moment where you focus on something without

distractions.
 31

Observation Report: Throughout the observation, the participant remained composed,

occasionally nodding while listening. Their facial expressions were neutral, with occasional

smiles when engaging in light conversation.

 32

CASE PRESENTATION 4

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : DMV PLACE :BANGALORE

AGE : 37 YEARS

GENDER : MALE

Socio-Demographic Details

The participant, DMV, is a 37-year-old male who follows the Hindu religion. He is married

and has completed a Master’s degree. He is self-employed in the timber industry and resides

in a rented home. His household consists of six members, with five dependents, indicating

significant financial responsibilities.

Despite belonging to the middle-class socio-economic group, the participant has health

insurance, ensuring access to medical care. Additionally, he engages in regular physical activity,

which may contribute to his overall well-being. Gujarati is the primary language spoken at

home, preserving cultural identity. The participant is an Indian citizen.

The assessment was conducted in a quiet and comfortable setting, ensuring a supportive

environment. The participant was informed of the voluntary nature of the assessment, the

absence of physical risks, and the right to withdraw at any time. The objective was to assess

the participant’s emotional and psychological well-being.

Case Analysis of BDI-II

 33

Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to evaluate the participant’s

level of depression. The participant received clear instructions before completing the

assessment under standardized conditions to ensure accuracy and reliability.

Interpretation of Results

The participant obtained a BDI-II score of 18, indicating Mild Depression. This suggests

noticeable but manageable depressive symptoms, which may intermittently affect daily life,

motivation, and emotional well-being.

Key symptoms include occasional sadness, reduced pleasure in activities, mild fatigue, and

emotional distress. However, there are no major disruptions in sleep, appetite, or concentration,

which suggests that while the participant experiences distressing emotions, they do not severely

impact cognitive or functional abilities.

Mild depression may stem from work-related stress, financial responsibilities, or personal

challenges. Given the participant’s role as a business owner and primary provider for a large

household, these pressures could contribute to emotional strain.

Conclusion

While the participant’s symptoms remain within a mild range, early intervention can help

prevent escalation. Stress management, structured routines, social support, and self-care

practices are recommended. If symptoms persist or intensify, professional psychological

support may be beneficial to enhance resilience and well-being.

 34

TABLE 4 : Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

DMV 37 18 Mild Depression

Case Analysis of MSE

A Mental Status Examination (MSE) was conducted to assess the participant's current

psychological functioning. The findings are as follows:

• Appearance: The participant was neatly groomed, indicating appropriate self-care and

attention to personal hygiene.

• Speech: Speech was normal in rate, tone, and volume, suggesting coherent and goal-

directed communication. There were no signs of speech abnormalities such as

tangentiality, pressured speech, or impoverishment.

• Eye Contact: The participant maintained normal eye contact, indicating comfort in

social interactions and the absence of avoidance behaviours.

• Motor Activity: The participant exhibited normal motor activity, with no signs of

psychomotor retardation or involuntary movements. However, behaviourally,

hyperactivity and agitation were observed, suggesting restlessness or heightened

physiological arousal.

• Affect: Affect was noted to be full, meaning the participant displayed a broad and

appropriate range of emotional expressions.

 35

• Mood: The participant reported feeling irritable and anxious, indicating underlying

emotional distress, nervousness, or frustration. Anxiety may contribute to hyperactivity

and agitation, while irritability may reflect heightened emotional sensitivity to external

stressors.

• Cognition: Orientation was fully intact, with no impairments in person, place, time, or

object recognition. Memory function was intact, with no signs of short-term or long-

term memory deficits. Attention was normal, suggesting the participant could maintain

focus during the evaluation.

• Perception: There were no hallucinations or perceptual disturbances, and the participant

did not report derealization or depersonalization experiences.

• Thought Content and Process: No suicidal or homicidal ideation, intent, or plans were

reported. Additionally, no delusions were present, and the participant's thought

processes appeared logical and organized.

• Behaviour: The participant was cooperative but exhibited hyperactivity and agitation.

The presence of hyperactivity suggests increased energy levels, restlessness, or

difficulty remaining still, while agitation may indicate frustration or emotional distress.

• Insight: Insight was good, meaning the participant demonstrated an understanding of

their emotional state and psychological well-being.

• Judgment: Judgment was good, reflecting the ability to make sound decisions and

respond appropriately to different situations.

Conclusion

The participant's cognitive and perceptual functions are intact, with good insight and judgment.
 36

However, the presence of anxiety, irritability, hyperactivity, and agitation suggests underlying

emotional distress or difficulty with emotional regulation. Hyperactivity and agitation,

combined with an anxious mood, could indicate heightened physiological arousal, difficulty

managing stress, or a potential anxiety-related disorder.

Although no immediate risk factors (such as suicidality or homicidally) are present, the

emotional symptoms and behavioural hyperactivity warrant further evaluation. If these

symptoms persist or interfere with daily functioning, additional psychological assessment and

intervention (such as stress management strategies or cognitive-behavioural techniques) may

be beneficial.

Introspection Report: At times, I caught myself thinking about past experiences, but I didn't

dwell on them. It was more of a passing thought, like remembering an old habit or routine.

Observation Report: The participant maintained steady eye contact and responded in a

confident and articulate manner. They occasionally leaned forward when discussing certain

topics, indicating active engagement.

 37

CASE PRESENTATION 5

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : VP PLACE :BANGALORE

AGE : 39 YEARS

GENDER : MALE

Socio-Demographic Details

The participant, VP, is a 39-year-old male who follows the Hindu religion. He is married and

has completed his master’s degree. He is self-employed in the timber industry and belongs to

the middle-class socioeconomic group. VP resides in a household of 11 members, with 9

dependents, reflecting a significant level of family responsibility.

He owns his home, providing financial stability, and has health insurance, ensuring medical

support when needed. However, he does not engage in regular physical activity, which may

have implications for his overall well-being. Gujarati is the primary language spoken at home,

reinforcing cultural identity. VP is a citizen of India.

The assessment was conducted in a quiet, well-lit setting, ensuring a comfortable and

confidential environment. Rapport was established to create a non-threatening atmosphere,

allowing for an open discussion of psychological and emotional well-being. Participation was

voluntary, and the participant was informed of his right to withdraw at any time without

consequences.

Case Analysis of BDI-II

 38

Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to assess the participant’s level

of depressive symptoms. Standardized instructions were provided:

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. If multiple statements apply, select the highest number in that group.

Ensure that only one statement is chosen for each group, including Item 16 (Changes in

Sleeping Pattern) and Item 18 (Changes in Appetite)."

The participant completed the assessment under standardized conditions to ensure accuracy

and reliability in responses.

Interpretation of Results

The participant obtained a BDI-II score of 26, which falls within the Moderate Depression

range. This indicates the presence of persistent depressive symptoms that may impact daily

functioning, emotional well-being, and overall quality of life.

VP likely experiences frequent sadness, decreased motivation, and significant difficulty

deriving pleasure from activities. His responsibilities as a business owner and head of a large

household with multiple dependents may contribute to elevated stress levels, which could

exacerbate emotional distress. Symptoms such as fatigue, difficulty concentrating, and possible

disruptions in sleep or appetite may be present, further affecting his daily performance and

interpersonal relationships.

While VP retains functional abilities, these symptoms suggest an increased risk of emotional

exhaustion and reduced coping capacity if left unaddressed. Psychological interventions such
 39

as cognitive-behavioral strategies, stress management techniques, and structured routine

modifications could be beneficial in mitigating distress. Seeking professional support may help

VP manage these challenges effectively.

Conclusion

The participant exhibits moderate depressive symptoms, which, while not severe, indicate a

need for early intervention. Addressing stressors related to workload, family responsibilities,

and lifestyle habits can help in maintaining mental well-being. Encouraging self-care, social

engagement, and professional consultation could prevent further deterioration and support

emotional resilience.

TABLE 5: Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

VP 39 26 Moderate Depression

Case Analysis of MSE

A Mental Status Examination (MSE) was conducted to evaluate the participant's current

psychological state. The findings are as follows:

• Appearance: The participant was neatly groomed, indicating adequate self-care and

attention to personal hygiene.

• Speech: Speech was normal in rate, tone, and volume, suggesting coherent and goal-

directed verbal communication. There were no indications of speech abnormalities such

as tangentiality, pressured speech, or impoverishment.

 40

• Eye Contact: The participant maintained normal eye contact, implying comfort in social

interactions and the absence of avoidance behaviours.

• Motor Activity: Motor behaviour was normal, with no signs of psychomotor retardation

or excessive movement.

• Affect: Affect was noted to be full, indicating a broad range of emotional expressions

that were contextually appropriate.

• Mood: The participant reported feeling irritable, which may suggest emotional distress,

heightened frustration, or sensitivity to external stimuli. Irritability can be associated

with mood instability, difficulty managing stress, or underlying emotional

dysregulation.

• Cognition: Orientation was fully intact, with no impairments in awareness of person,

place, time, or objects. Memory function was intact, with no signs of short-term or long-

term memory deficits. Attention was normal, indicating the ability to concentrate and

engage with the assessment process.

• Perception: There were no hallucinations or perceptual disturbances, and the participant

did not report derealization or depersonalization experiences.

• Thought Content and Process: No suicidal or homicidal ideation, intent, or plans were

reported. Additionally, no delusions were present, and thought processes appeared

logical and coherent.

• Behaviour: The participant exhibited stereotyped, aggressive, and agitated behaviour.

Stereotyped behaviour refers to repetitive, purposeless movements or actions, which

could indicate underlying stress, impulsivity, or a response to internal emotional

 41

distress. The presence of aggression and agitation suggests heightened emotional

arousal and difficulty regulating responses to external stimuli.

• Insight: Insight was good, meaning the participant demonstrated an awareness of their

emotional state and psychological well-being.

• Judgment: Judgment was fair, indicating some ability to make appropriate decisions

but also potential difficulties in impulse control or problem-solving under stress.

Conclusion

The participant's cognitive and perceptual functions are intact, with good insight but fair

judgment. However, the presence of irritability, aggression, agitation, and stereotyped

behaviour suggests emotional dysregulation, frustration, or possible difficulties with impulse

control. Stereotyped behaviour can sometimes be associated with anxiety, compulsive

tendencies, or heightened stress responses, while agitation and aggression may indicate

underlying frustration or difficulty managing emotions.

Although there are no immediate risk factors (such as suicidality or homicidally), the fair

judgment and behavioural symptoms suggest potential difficulties in coping with stress,

regulating emotions, or responding adaptively to challenging situations. Further psychological

evaluation may be beneficial to assess emotional regulation, behavioural patterns, and coping

strategies.

Introspection Report: My thoughts were clear, and I moved through things steadily. It felt like

one of those moments where you slow down a bit and notice yourself in the present.

Observation Report: The participant appeared well-groomed and neatly dressed, presenting

themselves in a professional manner. They showed no signs of distress, maintaining a steady

pace while completing the task.

 42

CASE PRESENTATION 6

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : VP PLACE :BANGALORE

AGE : 38 YEARS

GENDER : FEMALE

Socio-Demographic Details

The participant, VP, is a 38-year-old female who follows the Hindu religion. She is married

and has completed a bachelor’s degree. She is a homemaker, managing household

responsibilities. Her family consists of six members, with four dependents, indicating a

moderately large household. The participant resides in a rented house, placing her within the

middle-class socioeconomic bracket. She has health insurance, providing financial support

during medical needs, but does not engage in regular physical activity. The primary language

spoken at home is Gujarati, maintaining her cultural and linguistic identity. She is an Indian

citizen.

The assessment was conducted in a quiet, well-lit environment, ensuring comfort and reliability

of responses. Rapport was established to create a non-threatening atmosphere, allowing for

open and honest responses. The participant was informed that the assessment was voluntary,

and she had the right to withdraw at any time. There were no physical risks involved, and

clarification was encouraged as needed.

Case Analysis of BDI-II

 43

Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to assess the participant’s level

of depression. Instructions were provided before the assessment:

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. Circle the number beside the chosen statement. If multiple statements

apply, select the highest number in that group. Ensure that only one statement is chosen for

each group, including Item 16 (Changes in Sleeping Pattern) and Item 18 (Changes in

Appetite)."

The participant completed the assessment under standardized conditions, ensuring the accuracy

and reliability of responses.

Interpretation of Results

The participant obtained a BDI-II score of 26, placing her in the Moderate Depression

category. This score suggests the presence of clinically significant depressive symptoms,

which may impact daily functioning, motivation, and emotional well-being.

Key reported symptoms include persistent sadness, decreased pleasure in activities, fatigue,

and difficulty concentrating. While there are no severe disruptions in basic functioning,

emotional distress and motivational difficulties are evident. The participant’s lack of regular

physical activity and high household responsibilities may contribute to increased stress and

emotional exhaustion.

Although moderate depression does not necessarily indicate major depressive disorder, it

warrants attention and intervention. Implementing structured routines, social engagement, and
 44

self-care strategies could help improve emotional well-being. If symptoms persist or intensify,

professional psychological support may be beneficial to prevent escalation into severe

depression.

Conclusion

The participant's symptoms suggest moderate depression, indicating the need for proactive

mental health management. While daily functioning remains intact, emotional distress and

fatigue may interfere with overall well-being. Lifestyle modifications such as exercise,

relaxation techniques, and structured daily activities can help alleviate symptoms.

Psychological counseling or therapy may be beneficial if symptoms persist or worsen. Regular

monitoring of mental health is recommended to ensure long-term emotional stability.

TABLE 6 : Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

VP 38 26 Moderate Depression

Case Analysis of MSE

A Mental Status Examination (MSE) was conducted to assess the participant's current

psychological state. The findings are as follows:

 45

• Appearance: The participant was neatly groomed, indicating adequate self-care and

attention to personal hygiene.

• Speech: Speech was normal in rate, tone, and volume, suggesting coherent and goal-

directed verbal communication with no abnormalities such as tangentiality, pressured

speech, or speech impoverishment.

• Eye Contact: The participant maintained normal eye contact, indicating a balanced level

of engagement in social interactions without avoidance or excessive intensity.

• Motor Activity: Motor behaviour was normal, with no signs of psychomotor agitation,

retardation, or involuntary movements.

• Affect: Affect was noted to be full, meaning the participant demonstrated a broad and

appropriate range of emotional expressions.

• Mood: The participant reported feeling irritable, which may indicate underlying

frustration, emotional distress, or sensitivity to external stressors.

• Cognition: Orientation was fully intact, with no impairments in awareness of person,

place, time, or objects. Memory function was intact, with no signs of short-term or long-

term memory deficits. Attention was normal, suggesting the participant could focus and

engage effectively during the assessment.

• Perception: No hallucinations or perceptual disturbances were reported, and the

participant did not experience derealization or depersonalization.

• Thought Content and Process: There were no suicidal or homicidal ideations, intent, or

plans. Additionally, no delusions were present, and the participant's thought processes

appeared logical and coherent.

 46

• Behaviour: The participant was guarded and agitated. Guarded behaviour suggests

reluctance to share personal thoughts or emotions, which may indicate distrust,

discomfort, or emotional defensiveness. Agitation may be linked to underlying stress,

emotional tension, or difficulty regulating frustration.

• Insight: Insight was good, meaning the participant demonstrated an awareness of their

emotional state and psychological well-being.

• Judgment: Judgment was good, suggesting the ability to make sound decisions and

respond appropriately to situations.

Conclusion

The participant's cognitive and perceptual functions are intact, with good insight and judgment.

However, the presence of irritability, guarded behaviour, and agitation may indicate emotional

distress, difficulty trusting others, or heightened sensitivity to stress. Guardedness could reflect

defensive coping mechanisms, while agitation may suggest frustration or restlessness.

Although no immediate risk factors (such as suicidality or homicidally) are present, the

emotional distress and guarded demeanour warrant further exploration into potential stressors,

underlying mood disturbances, or anxiety-related concerns. If these symptoms persist,

therapeutic interventions such as cognitive-behavioural therapy (CBT), relaxation techniques,

or emotional regulation strategies may be helpful in improving coping mechanisms.

Introspection Report: I felt comfortable as I worked through the process. There were no strong

emotions, just a steady awareness of what I was doing in the moment.

Observation Report: Sitting upright with hands resting on the table, the participant appeared at

ease. Their speech was clear, and they engaged in casual conversation before and after the

session, demonstrating a sociable nature.

 47

CASE PRESENTATION 7

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : GV PLACE :BANGALORE

AGE : 36 YEARS

GENDER : FEMALE

Socio-Demographic Details

The participant, GV, is a 36-year-old female who follows the Hindu religion. She is married

and has completed her Master’s degree. She is a homemaker, responsible for managing

household responsibilities. Her household consists of five members, including three

dependents, indicating a structured family environment.

GV belongs to the middle-class socioeconomic group and resides in an owned house, reflecting

financial stability. She has health insurance, ensuring access to medical care. Unlike many

homemakers, GV engages in regular physical activity, which contributes positively to her

overall well-being. Kannada is the primary language spoken at home, reinforcing her cultural

background. She is a citizen of India.

The assessment took place in a calm and private environment, ensuring participant comfort and

accurate responses. The participant was informed about the voluntary nature of the assessment

and assured of confidentiality. The assessment aimed to evaluate her emotional well-being and

contribute to potential mental health support strategies.

Case Analysis of BDI-II

 48

Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to assess the participant’s level

of depression. Standardized instructions were provided to ensure clarity and reliability of

responses:

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. Circle the number beside the chosen statement. If multiple statements

apply, select the highest number in that group. Ensure that only one statement is chosen for

each group, including Item 16 (Changes in Sleeping Pattern) and Item 18 (Changes in

Appetite)."

The participant completed the assessment under standardized conditions, ensuring validity and

accuracy in the recorded responses.

Interpretation of Results

The participant obtained a BDI-II score of 30, indicating Severe Depression. This suggests

significant distress, likely impacting daily functioning, emotional well-being, and overall

quality of life.

GV's responses indicate persistent sadness, loss of pleasure in activities, fatigue, and emotional

distress, which align with clinical depressive symptoms. She may experience difficulty

concentrating, feelings of worthlessness, and increased emotional reactivity, including

heightened agitation and crying spells. Additionally, sleep and appetite disturbances may

contribute to her overall distress.

 49

Given the severity of symptoms, professional psychological support is strongly recommended.

Therapeutic interventions such as cognitive-behavioral therapy (CBT), structured daily

routines, social engagement, and lifestyle modifications may help manage symptoms. If

symptoms persist or worsen, further clinical evaluation and psychiatric consultation may be

necessary to explore treatment options, including medication.

Conclusion

The participant exhibits severe depressive symptoms, which may significantly impact daily life.

Early intervention is crucial to prevent symptom escalation. A comprehensive mental health

plan, including professional therapy, social support, and self-care strategies, is advised to

enhance well-being and improve quality of life.

TABLE 7: Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

GV 36 30 Severe Depression

Case Analysis of MSE

A Mental Status Examination (MSE) was conducted to assess the participant's current

psychological state. The findings are as follows:

 50

• Appearance: The participant was neatly groomed, indicating appropriate self-care and

personal hygiene.

• Speech: Speech was normal in rate, tone, and volume, suggesting clear, coherent, and

goal-directed communication without abnormalities such as tangentiality, pressured

speech, or impoverished speech.

• Eye Contact: The participant maintained normal eye contact, demonstrating appropriate

social engagement and comfort in interactions.

• Motor Activity: Motor behaviour was normal, with no signs of psychomotor agitation,

retardation, or involuntary movements.

• Affect: Affect was full, indicating that the participant displayed a broad range of

emotional expressions that were appropriate to the context.

• Mood: The participant reported feeling calm and attentive, suggesting a stable

emotional state, a sense of control, and an ability to focus on the assessment without

signs of distress or dysregulation.

• Cognition: Orientation was fully intact, with no impairments in awareness of person,

place, time, or objects. Memory function was intact, with no indications of short-term

or long-term memory deficits. Attention was normal, suggesting the participant could

concentrate effectively.

• Perception: No hallucinations or perceptual disturbances were reported, and the

participant did not experience derealization or depersonalization.

 51

• Thought Content and Process: There were no suicidal or homicidal ideations, intent, or

plans. Additionally, no delusions were present, and the participant's thought processes

appeared logical and well-organized.

• Behaviour: The participant was cooperative but agitated. While cooperation suggests a

willingness to engage in the evaluation process, agitation may indicate underlying

restlessness, emotional tension, or sensitivity to certain stimuli.

• Insight: Insight was good, meaning the participant demonstrated an awareness of their

emotional state and mental well-being.

• Judgment: Judgment was good, reflecting the ability to make sound decisions and

respond appropriately to various situations.

Conclusion

The participant presents with intact cognitive and perceptual functions, along with good insight

and judgment. The calm and attentive mood suggests emotional stability, but the presence of

agitation despite cooperation could indicate mild underlying stress, internal tension, or a

reaction to external stimuli.

Although there are no immediate concerns related to mood dysregulation, cognitive

impairment, or thought disturbances, the occasional agitation warrants further exploration into

potential situational stressors or emotional triggers. If this pattern persists, interventions such

as relaxation techniques, stress management strategies, or mindfulness practices could be

helpful in maintaining emotional regulation.

 52

Introspection Report: I remained focused, though my mind occasionally drifted. It wasn't

anything too deep-just small thoughts about life, responsibilities, and the usual day-to-day

things.

Observation Report: The participant exhibited a thoughtful approach, taking their time before

responding. They occasionally tapped their fingers on the desk, seemingly deep in thought, but

showed no signs of anxiety or discomfort.

 53

CASE PRESENTATION 8

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : RK PLACE :BANGALORE

AGE : 40 YEARS

GENDER : FEMALE

Socio-Demographic Details

The participant, RK, is a 40-year-old female who follows the Hindu religion. She is married

and has completed her education up to a professional degree. While previously employed as a

teacher, she is currently a homemaker. She resides in a household of five members, with two

dependents. Despite belonging to the lower middle class, she owns her home, indicating

financial stability. RK has health insurance, which provides security in medical situations,

and engages in regular physical activity, contributing to her overall well-being. Kannada is

the primary language spoken at home, reflecting her cultural background. She is a citizen of

India.

The assessment was conducted in a quiet and comfortable setting to ensure a supportive and

non-threatening environment. The participant was informed about the purpose of the

assessment, confidentiality, and her right to withdraw at any time. She was assured that there

were no physical risks involved.

Case Analysis of BDI-II

Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to assess the participant’s

depressive symptoms. Standardized instructions were provided:

 54

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. If multiple statements apply, select the highest number in that group.

Ensure that only one statement is chosen per group."

The assessment was conducted under standardized conditions to ensure accuracy and reliability

in responses.

Interpretation of Results

The participant obtained a BDI-II score of 12, which falls within the Minimal Depression

range. This suggests the presence of mild depressive symptoms that do not significantly

impair daily functioning but may influence mood, motivation, and energy levels.

RK reported occasional sadness, mild loss of pleasure in activities, and slight fatigue. She did

not indicate significant disturbances in sleep, appetite, concentration, or self-worth, suggesting

that while some emotional distress is present, it is not pervasive. Her engagement in regular

physical activity may serve as a protective factor against worsening symptoms.

While her symptoms do not meet clinical thresholds for major depressive disorder, continued

self-care, social engagement, and stress management can help maintain emotional well-being.

If symptoms persist or intensify, further psychological assessment and intervention may be

beneficial.

Conclusion

The participant exhibits minimal depressive symptoms, which currently do not interfere

significantly with daily life. However, occasional sadness and mild fatigue suggest the

importance of early intervention through self-care and healthy lifestyle choices. Regular
 55

physical activity and emotional support from family may contribute to long-term well-being.

If symptoms persist or escalate, professional consultation should be considered to prevent

further emotional distress.

TABLE 8: Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

RK 40 12 Minimal Depression

Case Analysis of MSE

A Mental Status Examination (MSE) was conducted to assess the participant's current

psychological state. The findings are as follows:

• Appearance: The participant was neatly groomed, indicating appropriate self-care and

personal hygiene.

• Speech: Speech was normal in rate, tone, and volume, suggesting coherent and goal-

directed verbal communication with no observed abnormalities such as pressured,

tangential, or impoverished speech.

• Eye Contact: The participant maintained normal eye contact, reflecting appropriate

social engagement without signs of avoidance or excessive intensity.

• Motor Activity: Motor behaviour was normal, with no signs of psychomotor retardation,

excessive movements, or involuntary tics.

 56

• Affect: Affect was full, indicating that the participant exhibited a broad and appropriate

range of emotional expressions.

• Mood: The participant reported feeling anxious and irritable, suggesting emotional

distress, heightened sensitivity to external stimuli, and possible difficulty managing

stressors.

• Cognition: Orientation was fully intact, with no impairments in awareness of person,

place, time, or objects. Memory function was intact, with no indications of short-term

or long-term memory deficits. Attention was normal, suggesting the participant could

concentrate and engage effectively.

• Perception: No hallucinations or perceptual disturbances were reported, and the

participant did not experience derealization or depersonalization.

• Thought Content and Process: Suicidal ideation was reported, though there were no

indications of intent or a plan. No homicidal ideation or delusions were observed, and

thought processes appeared logical and well-organized.

• Behaviour: The participant was cooperative but agitated. Cooperation suggests a

willingness to engage in the assessment, but agitation may indicate internal distress,

emotional turmoil, or heightened nervousness.

• Insight: Insight was good, meaning the participant demonstrated an awareness of their

emotional state and psychological well-being.

• Judgment: Judgment was good, reflecting the ability to make sound decisions and

respond appropriately to various situations.

 57

Conclusion

The participant demonstrates intact cognitive and perceptual functioning, with good insight

and judgment. However, anxiety, irritability, agitation, and suicidal ideation indicate

significant emotional distress. While there is no structured suicidal plan or intent, careful

monitoring and further assessment are necessary. Agitation may reflect emotional

dysregulation or difficulty coping with distressing thoughts, while irritability and anxiety

suggest mood instability or heightened stress reactivity.

Despite being cooperative, the participant's agitation indicates underlying discomfort. The

absence of hallucinations, delusions, or homicidal ideation is reassuring, but suicidal ideation

requires further evaluation to assess frequency, intensity, and triggers. If distress persists,

psychological therapy, emotional regulation strategies, and supportive counselling may be

beneficial. In cases of worsening ideation, crisis intervention, safety planning, or psychiatric

referral should be considered.

Introspection Report: It felt like a routine task at first, but as I went along, I noticed myself

paying more attention. It made me think about things I don't usually take time to consider.

Observation Report: Maintaining a neutral facial expression, the participant showed patience

throughout the process. Their tone remained steady, and they occasionally adjusted their

posture to remain comfortable.

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CASE PRESENTATION 9

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : MRP PLACE :BANGALORE

AGE : 35 YEARS

GENDER : MALE

Socio-Demographic Details

The participant, MRP, is a 48-year-old male who follows the Hindu religion. He is married

and has completed his education up to high school. He is a business owner, actively engaged

in professional responsibilities. The participant lives in a four-member household, with one

dependent. His upper-middle-class socioeconomic status and homeownership reflect financial

stability.

Regarding health and wellness, MRP has health insurance and engages in regular physical

activity, which supports overall well-being. Gujarati is the primary language spoken at home,

reinforcing cultural identity. He is a citizen of India.

The assessment took place in a well-lit and quiet setting, ensuring a comfortable and

professional atmosphere. The participant was informed about the voluntary nature of the

assessment, the absence of physical risks, and the right to withdraw at any time.

Case Analysis of BDI-II

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Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to assess the participant’s level

of depression. Standardized instructions were provided:

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. Circle the number beside the chosen statement. If multiple statements

apply, select the highest number in that group. Ensure that only one statement is chosen for

each group, including Item 16 (Changes in Sleeping Pattern) and Item 18 (Changes in

Appetite)."

The participant completed the assessment under standardized conditions to ensure accuracy

and reliability.

Interpretation of Results

The participant obtained a BDI-II score of 14, placing him in the Mild Depression range. This

indicates the presence of mild depressive symptoms, which may subtly affect mood,

motivation, and daily functioning.

Key responses suggest occasional sadness, slight reduction in pleasure from activities, and mild

fatigue. The participant maintains functional concentration, stable sleep, and appetite patterns,

reducing the risk of significant impairment. However, mild emotional distress, if unaddressed,

can contribute to increased stress levels over time.

Psychological research suggests that early identification of mild depressive symptoms allows

for timely intervention. Strategies such as stress management, structured routines, and social

engagement can help maintain emotional resilience.

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Conclusion

While the participant’s symptoms are mild, monitoring mood patterns and engaging in self-

care are recommended. If symptoms persist or intensify, further psychological assessment and

intervention may be beneficial to prevent escalation.

TABLE 9: Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

MRP 35 14 Mild Depression

Case Analysis of MSE

A Mental Status Examination (MSE) was conducted to assess the participant's current

psychological functioning. The findings are as follows:

• Appearance: The participant appeared dishevelled, suggesting possible neglect of self-

care, which may indicate emotional distress or difficulties in daily functioning.

• Speech: Speech was normal in rate, tone, and volume, indicating coherent and goal-

directed verbal communication.

• Eye Contact: The participant's avoidant eye contact suggests discomfort, social

withdrawal, or anxiety, potentially indicating distrust, emotional distress, or low self-

confidence.
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• Motor Activity: Motor behaviour was normal, with no signs of psychomotor retardation

or excessive movement.

• Affect: Affect was full, indicating a broad range of emotional expressions appropriate

to the context.

• Mood: The participant reported feeling anxious and irritable, suggesting underlying

emotional distress and heightened sensitivity to stressors.

• Cognition: Orientation was fully intact, with no memory impairments, and attention

was normal, indicating intact cognitive functioning.

• Perception: No hallucinations, derealization, or depersonalization were reported.

• Thought Content and Process: No suicidal or homicidal ideation, intent, or delusions

were present, and the participant's thought processes appeared logical and coherent.

• Behaviour: The participant was cooperative but also displayed agitation, stereotyped

behaviour, and aggression. Agitation may indicate emotional distress or frustration,

while stereotyped behaviour (repetitive movements or actions) may suggest underlying

anxiety or compulsive tendencies. Aggression may be a response to distress or difficulty

regulating emotions.

• Insight: Insight was good, indicating awareness of personal emotions and behaviours.

• Judgment: Judgment was fair, suggesting some difficulties in decision-making, impulse

control, or problem-solving under stress.

Conclusion

The participant presents with intact cognitive and perceptual functioning, but dishevelled
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appearance, avoidant eye contact, anxiety, irritability, agitation, and aggression indicate

emotional distress, difficulty with self-regulation, and possible underlying mood or anxiety-

related concerns. The stereotyped behaviour suggests heightened internal tension or

compulsive tendencies, while fair judgment may indicate challenges in managing stressors or

making adaptive decisions.

Introspection Report: I answered each question as it came, not rushing but not overthinking

either. Some thoughts felt familiar, while others made me stop for a moment before moving

on.Observation Report: The participant engaged attentively, occasionally taking brief pauses

before responding. Their demeanour was cooperative, and they exhibited good listening skills

by acknowledging questions with slight nods

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CASE PRESENTATION 10

ASSESSOR : JP DATE :09/03/2025

ASSESSEE : AVP PLACE :BANGALORE

AGE : 45 YEARS

GENDER : MALE

Socio-Demographic Details

The participant, AVP, is a 45-year-old male who follows the Hindu religion. He is married

and has completed his education up to a bachelor’s degree. AVP is self-employed in business,

contributing to the family’s financial stability. The participant resides in a household of six

members, with two dependents, and owns his home, reflecting upper middle-class

socioeconomic status.

AVP has health insurance, ensuring access to medical care, but does not engage in regular

physical activity, which may impact overall well-being. Gujarati is the primary language

spoken at home, maintaining cultural roots. The participant is a citizen of India.

The assessment was conducted in a quiet, well-lit setting to ensure a comfortable and

supportive environment. Rapport was established to promote openness and reliability in

responses. Participation was voluntary, with the right to withdraw at any point. The participant

was informed of the confidential nature of the assessment and assured that there were no

physical risks involved.

Case Analysis of BDI-II

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Assessment Administration

The Beck Depression Inventory-II (BDI-II) was administered to assess the participant’s level

of depression. Standardized instructions were provided:

"This questionnaire consists of 21 groups of statements. Please read each group carefully and

select the one statement that best describes how you have been feeling during the past two

weeks, including today. Circle the number beside the chosen statement. If multiple statements

apply, select the highest number in that group. Ensure that only one statement is chosen for

each group, including Item 16 (Changes in Sleeping Pattern) and Item 18 (Changes in

Appetite)."

The participant completed the assessment under standardized conditions, ensuring reliability

and accuracy in responses.

Interpretation of Results

The participant obtained a BDI-II score of 7, which falls within the Minimal Depression

range. This suggests an absence of clinically significant depressive symptoms. The

participant may experience mild mood fluctuations, occasional low energy or motivation, but

these do not interfere with daily functioning or emotional well-being.

Responses indicate no significant disturbances in sleep, appetite, concentration, or self-worth.

While occasional emotional distress can be part of normal life experiences, maintaining healthy

coping mechanisms, social engagement, and stress management strategies is beneficial for

overall mental well-being.

Conclusion

The participant's BDI-II score does not indicate clinical depression, and no immediate
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psychological intervention is necessary. However, promoting work-life balance, regular

physical activity, and emotional awareness may enhance long-term well-being. If symptoms

increase or persist, further psychological evaluation may be considered.

TABLE 10: Showing the Raw scores and Interpretation obtained by the participant.

INITIAL AGE RAW SCORE INTERPRETATION

AVP 45 7 Minimal Depression

Case Analysis of MSE

A Mental Status Examination (MSE) was conducted to assess the participant's current

psychological state. The findings are as follows:

• Appearance: The participant was neatly groomed, indicating adequate self-care and

attention to personal hygiene.

• Speech: Speech was normal in rate, tone, and volume, reflecting coherent and goal-

directed verbal communication.

• Eye Contact: The participant maintained normal eye contact, suggesting comfort in

social interactions without signs of avoidance or excessive intensity.

• Motor Activity: Motor behaviour was normal, with no indications of psychomotor

agitation or retardation.

• Affect: Affect was full, indicating a broad and appropriate range of emotional

expressions.
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• Mood: The participant reported feeling anxious and irritable, suggesting emotional

distress, heightened sensitivity to stressors, or difficulty managing frustration.

• Cognition: Orientation was fully intact, with no impairments in memory or attention,

indicating preserved cognitive functioning.

• Perception: No hallucinations, derealization, or depersonalization were reported.

• Thought Content and Process: No suicidal or homicidal ideation, intent, or delusions

were present, and the participant's thought processes appeared logical and well-

organized.

• Behaviour: The participant was cooperative but also agitated and aggressive. Agitation

may indicate emotional discomfort or restlessness, while aggressive behaviour could

suggest difficulty in emotional regulation or frustration with external or internal

stressors.

• Insight: Insight was good, reflecting awareness of emotions and behaviours.

• Judgment: Judgment was good, suggesting an ability to make sound decisions despite

emotional distress.

Conclusion

The participant presents with intact cognitive and perceptual functioning, demonstrating good

insight and judgment. However, anxiety, irritability, agitation, and aggression suggest

emotional distress and potential difficulties in managing frustration or stressors. While

cooperative, the participant's agitation and aggression may indicate difficulty in impulse

control or heightened emotional reactivity.

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Introspection Report: As I sat down, I took a moment to gather my thoughts. I felt calm but

aware of how much I had on my mind. It was a quiet pause in my day, giving me time to reflect.

Observation Report: Appearing focused and attentive, the participant maintained a steady

rhythm in their responses. They showed no visible signs of distress or discomfort and

completed the task with quiet confidence.