PSYCHOLOGICAL REPORT

I. Identifying Information
Name: “Lara”
Age/Sex: 19 ½ years old Female
Address: Imus, Cavite
Birthdate: April 9, 1990
Civil Status: Single
Religion: Roman Catholic
Educational Attainment: 4th year college student
II. Presenting Complaint
Bulimia Nervosa
III. Case Background
“Lara” is a 19 ½ year old female presenting with symptoms of Bulimia Nervosa.
She is 5 feet 5 inches tall and weighs 112 lbs. with a small to medium frame size. She is
the only daughter of three children and has two brothers, ages 21 and 15.
The bulimia started in high school but her concern with weight started a few
years before that. Her symptoms of bingeing, purging and excessive exercising started
when she was 15 years old and a senior student in Imus Institute in Cavite. In the
beginning, she kept her weight in control by restricting on foods (no rice or any foods
rich in carbohydrates), counting calories and running 7 times a week for 2 hours. Her
daily intake is as follows: no breakfast, no lunch, snack (fruits), heavy dinner, and
bingeing all night. She throws up once before she goes to bed.
According to her, her view of herself is always in terms of what she’s not, what
she hasn't accomplished which she says are a sum of her failures, instead of a sum of
success. She is a high achiever and is known as the girl who could do everything and
was most likely to succeed. People around her always tell her how lucky she was but
she never really saw herself to be lucky.
Lara’s concern over with weight was a sum of other people’s influences, most
notably her mother’s. According to her, weight, appearance and overall self-worth was
an issue that troubled her mother most her life and so her mother was determined to
prevent that from happening to her. Whenever they go shopping for clothes or during
dinner, her mother would say harsh criticisms like “You are a pretty girl and you
shouldn’t be walking around with thighs like that”. Her extended family would say jokes
about the portion of food her mother used to give to her during occasions like” That
amount of food would fit a thimble”. After eating a large amount of food in during dinner,
she feels guilty about it and is disgusted with what she did and so she throws up before
she goes to bed. This started the cycle of bingeing and purging to control her weight.
IV. Observation
The client was properly groomed and was able to maintain her personal hygiene.
She was completely at ease and was able to make good social contact with the
interviewer. She showed interest and cooperation during the interview and in doing the
tests. She was able to establish rapport with the interviewer. She speaks fluently in
English with a medium volume of voice which the interviewer can understand what she
was saying. She was attentive to the interview and in taking the test. Though she
showed a general tendency to be over critical with herself when asked about how she
sees herself (weight, body image, self-concept).
V. Psychological Test and Interpretation
Draw-A-Person Test February 2, 2010
Sachs Sentence Completion Test February 2, 2010
In summary, test results showed that the client clearly rejects and depreciates
her mother while also feeling rejected by her own family. Based on the interview, the
client’s family especially her mother is very critical with her weight and keeps on
pressuring her to be thin. They would make harsh criticisms and jokes about her weight
during dinner or family gatherings. She has no control over her impulsive behavior ion
terms of eating and vomiting. According to her, when dinner is served she simply cannot
stop to eat though she already feels full. She can’t control either the need to vomit/purge
it before going to bed. She is overly concerned with her appearance especially with her
body shape. According to her, she worries about how others see her and is always
concern of looking attractive.

VI. Analysis
 Lara’s assessment using the Draw-a-Person Test and Sachs Sentence
Completion Test provided a basis for understanding the client’s unconscious feelings
towards herself and others especially with her family.
The client feels pressured to conform with her mother’s desire to look good and
stay thin. She cannot handle the criticisms coming from her mother and family about her
weight. She admits of being a high-achiever and is always concern with her
appearance. She has never been overweight but because of other people’s influences
especially her mother’s comments about her body, it clearly affected her self-esteem
and how she sees herself now. After eating a large amount of food, she feels guilty
about it and is disgusted with what she did and so she throws up before she goes to
bed. This started the cycle of bingeing and purging to control her weight. It made her to
be self-critical with her body shape and weight and it lead to having Bulimia Nervosa.
VII. Diagnostic Impression
Axis I 307.51 Bulimia Nervosa
Axis II None
Axis III None
Axis IV Psychosocial problem: problems with primary support
group (family); criticisms from her mother about her body
shape and weight; jokes coming from her relatives
Axis V Current Global Assessment of Functioning: 60 ( Behavior
has considerable difficulty in social functioning and has
occasional impulsive behavior with eating and vomiting but
generally can function well in other areas like school)

Differential Diagnosis
Rule in Rule out
Bulimia Nervosa Anorexia Nervosa
Anorexia Nervosa Binge-Eating/Purging Type Binge-Eating/Purging Type
Eating Disorder NOS Eating Disorder NOS

• Anorexia Nervosa Binge-Eating/Purging Type was disregard because the

client didn’t meet the criteria for this disorder. The client still has regular
menses and the binge-eating occurs for a discrete period of time (during
dinner) and vomiting occurs after a large amount of food has been eaten. The
client also has a normal weight unlike with individuals with Anorexia Nervosa
who are underweight of body weight is less than 85% of that expected. The
client’s BMI is 18.6 which is a normal weight for her age.
• Eating Disorder NOS was also disregard because the client didn’t meet the
criteria wherein there is repeated chewing and spitting out, but not swallowing
large amounts of food and with the binge-eating disorder. The client is clearly
fixated on body shape and weight that why she engages both with binge-
eating (eating large amounts of food during dinner) and purging (throwing up
before going bed) to control her weight. She laso controls her weight by
counting calories, restricting on certain foods (no rice or food rich in
carbohydrates) and excessive exercise.