Munira Punjuani Case Summary

Statement of the Problem

Munira Punjuani was seen for an evaluation at the Family Counseling Center on April 11th in order to assess if criteria for Posttraumatic Stress Disorder are present and to determine current psychological stability in determination for visa eligibility .

Background Information

Ms. Punjuani is a 27 year old female who was a victim in a robbery about a year ago. Ms. Punjuani recalls that she was helping her cousins at their convience store outside of Knoxville when two teenage males came in between nine and ten o’clock at night. She reported that her memories are a bit “foggy” due to the timeframe since it has occured. She went on to report that the two males, one white and one african american, wore masks and

had guns in their hands. She recalls that at first she thought it was some kind of joke, however quickly realized it was not. She stated that one of the males covered the front door, while the other was at the cashbox and demanded the money from the drawer. She recalls opening the drawer and feeling unsure proceeded to hand him the money and then pull it back frusterating the guy, in which she expressed his response was to threaten to shoot her while “snatching” the money from her hand. At this time she kept pushing the panic button until the cops arrived. She recalled that it took them awaile, in which she stated they thought it was “pushed on accident.” The cops reviewed the security camera footage and took fingerprints and Ms. Punjuani’s statement. To date Ms. Punjuani doe snot know the outcome of the incident or if they were apprehended, however was made aware that these two males were also linked to a robbery at another store.

Following the incident, Ms. Pujuani reports that she felt herself withdrawing into herself and becoming hyper-aware to the point of paranoia. Stating that she wouldn’t go out on her own or after dark, she didn’t listen to the news and found herself isolating away from others and experiencingn difficulty sleeeping at night. As she began to experience headaches she realized that she needed help and seeked out counseling for herself.

Now Ms. Punjuani continues to be hyper-aware, however has gained an awareness of herself and her surroundings. Although she continues limit when she chooses to go out in the community, she continues to try to not let it affect how she sees others as she has identified that her sense of self and sense of safety have been profoundly impacted due to this incident.

Observations & Assessment Results

Ms.

Punjuani presented self in an appropriate manner. At times throughout the interview, she became slightly emotional while discussing her history and traumatizations. Ms. Punjuani appeared open to questions. The clinician conducted the diagnostic interview and had Ms. Punjuani complete the TSI-2 in order to determine if Ms. Punjuani fit criteria for PTSD.

Mental Health Interview:

Ms. Punjuani presented in a forthright and appropriate manner. Her affective responses were appropriate to the occasion. Her thought processes were logical and sequential. Ms. Punjuani was able to demonstrate knowledge of right and wrong; appropriate and inappropriate situations; healthy and unhealthy behaviors. There was no evidence to suggest a formal thought disorder or delusional thinking. At the time of interview, Ms. Punjuani denied suicidal or homicidal ideation.

Ms. Punjuani reported that she continues to experience overwhelming feelings of stress; experience flashbacks related to recent trauma experiences; and anxiety regarding current situation. She has indicated that she continues to work through her past choices and identify patterns of unhealthy behaviors in order to become a better person. Ms. Punjuani demonstrates a strong work/school ethic. This has allowed her to reflect on her past, where she is presently, and what she needs to change in order to have a better

future.

Trauma Symptom Inventory-2 (TSI-2):
The TSI-2 is designed to evaluate posttraumatic stress and other psychological effects of traumatic events, including the effects of sexual and physical assault, intimate partner violence, combat, torture, motor vehicle accidents, mass casualty events, medical trauma, traumatic losses, and childhood abuse or neglect. The TSI-2 assesses a wide range of potentially complex symptomatology, ranging from PTSD, dissociation, and somatization to insecure attachment styles, impaired self-capacities, and dysfunctional behaviors.

Validity scales have found that Ms. Punjuani answered questions in a non-defensive consistent manner with no minimization of symptomology found. It is important to note that scores on the ATR scale indicate possible tendency to over-report symptomology.

Factor scales indicate that Ms. Punjuani is found to exhibiting significant symptomology related to posttraumatic stress (PTS); and problematic symptomology related to a decreased sense of self-disturbance (SELF).

Examination of the clinical scale/subscales found that she is experiencing clinically significant levels of an impaired self-reference (ISR) often found in emotionally and mentally abusive situations and significant levels of anxious-arousal (AA); anxiety (AA-A); hyperarousal (AA-H); depression (D); defensive avoidance (DA); insecure attachment (IA); rejection sensitivity (IA-RS); and intrusive experiences (IE) such as flashbacks or memories associated with basic needs not being stabilized.

Generally, Ms. Punjuani did not respond to the items in a defensive manner, in keeping with her general presentation throughout the assessment. The TSI-2 profile is therefore consistent with Ms. Punjuani’s self-report and symptomatology present. Scores indicate that Ms. Punjuani fits criteria for Posttraumatic Stress Disorder (PTSD). Clinical Observations are in agreement with this finding.

Summary

Ms.

Punjuani has an extensive education background, in which she has earned a graduate degree in Psychology from India. Upon moving to the United States in 2011 on a student visa she found herself striving to become a nurse. This led her to her current achievement of being a graduate student at Carson University in which she is majoring in Mental Health Counseling. At time of assessment, Ms. Punjuani was completing her internship at Health Connect. She reports that although her traumatization has affected her on many levels, that she finds that it doe snot consume her, that her studies in the field have helped her to identify patterns, symptoms and coping skills in order to function fully and achieve her goals. Stating that she has begun the process of normalizing the incident, educating self on actions and the kind of people who victimize

others.

Although there is no guarantee of someone’s behavior, based on the assessments and evaluation completed on April 11, 2016 there is no evidence to suggest that Ms. Punjuani is a threat to herself or somebody else, but that she is a women who has suffered a traumatic experience and is trying to put her life back together in order to define herself as a survivor and not a victim.