PSYCHOLOGIC

AL EXPERT
REPORT.
PROFICIENT:

CRISTINA GARCÍA MARTÍNEZ, BACHELOR IN PSYCHOLOGY FROM

THE UNIVERSITY OF GRANADA, MASTER IN MENTAL HEALTH FROM
THE UNIVERSITY OF ALMERÍA AND MASTER IN CLINICAL, LEGAL AND
FORENSIC PSYCHOLOGY FROM THE COMPLUTENSE UNIVERSITY OF
MADRID.

EXPERT: DOÑA LM

No. of procedure/court of origin.

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 INDEX:

1.- IDENTIFICATION DATA……………………………………………………………………………………..…Page 3.

2.- OBJECT OF THE EXPERTISE………………………………………………………………………………......……….……

Page 3 .

3.- METHODOLOGY…………………………………………………………………………………………..…………..Page. 3-5.

3.1.- Interviews and observations…………………………………………………………………………..…......

….Pág.3.

3.2.- Complementary tests………………………………………………………………………………......Pág.3-4.

3.3.- Documentation examined……………………………………………………………………...………..…Page. 4-5.

4.- DESCRIPTIVE ANALYSIS………………………………………………………………………………...………Page 5-11.

4.1.-Sociodemographic data…………..…………………………………………………………………….………Page 5.

4.2.- Current situation………………….…………………………………………………..…………………..Pág.5-6 .

4.3.-Psychobiographical evolution…………………………………………………………….
……………………....Pág.6-8.

4.4.- Descriptive-functional analysis of the current symptoms………………………….

…………………………………………………………………….……… ………..…Pages 8-10.

4.5.- Interviews conducted with other sources……………………………………………………………………...

……..Page. 10.

4.6.- Risk and/or vulnerability factors………………………………………………………………………………Page

11.

5.- PSYCHOPATHOLOGICAL EXPLORATION…………………………………………………………..……...…………Page.

12-13.

6.-RESULTS OF COMPLEMENTARY TESTS…………………………………………………………...…………Page. 13-20.

6.1.- Revised 90 Symptoms Questionnaire “SCL-R-90”………………………………………………..Page. 13-14.

6.2.- State Anxiety Questionnaire-Trait “STAI”……………………………………………….……..Page. 15-16.

6.3.- Factorial Personality Questionnaire “16-PF-5”…………………………………………………………..Page. 16-

17.

6.4.- Restructured Minnesota Multiphasic Personality Inventory-2 “MMPI-2-

RF”……………………………………………………………………………… …………………..…………..P. 17-18.

6.5.- Leyman psychological harassment strategies questionnaire, “LIPT 60”……………………………..Page. 18-

19.

6.6.- Beck Depression Inventory “BDI”…………………………………………………………………….. P. 18-19.

6.7.- Data integration……………………………………………………..………………………………..Page. 19-20.

7.- CLINICAL JUDGMENT……………………………………………………………………………………………………Page.

20.

8.- FORENSIC FORMULATION…………………….…………………………………………………………...……… Page. 20-

22.

9.- FORENSIC DISCUSSION…………………………………………………………………………………..…..….Page. 23-27.

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 9.1.- Current status of Mrs. Martínez…………………………………………………………………….………….Page.
23-24.

9.2.- Stressful situation identified by Ms. Martínez as workplace harassment………………….…….…Page. 24-26.

9.3.- Causality and Simulation……………………………………………………………………………….Page. 24-27.

9.4.- Treatment and Prognosis………………………………………………………………………………......Page. 27.

10.- BIBLIOGRAPHICAL REFERENCES……………………………………………………...…..……………………Page. 28-

29.

11.- CONCLUSIONS……………………………………………………………………..………..……………………..Page. 29-30.

1.- IDENTIFICATION DATA .

 Identification data of the experts.

1. Ms. CRISTINA GARCÍA MARTÍNEZ, member number ……………..
Graduate in Psychology from the University………,

 Identification data of the expert.

Mrs. LM, 54 years old, born on June 8, 1960 in Madrid.

2.- OBJECT OF THE EXPERTISE .

At the request of Mr. Lawyer in legal representation of Ms. Martínez, a

psychological expert evaluation is requested to determine the possible existence of
injuries or psychological consequences in relation to the work situation.

3.- METHODOLOGY.

For the issuance of this psychological report we have had the following
interviews and complementary clinical tests carried out:

3.1.- INTERVIEWS AND OBSERVATIONS:

- Semi-structured clinical interview with Ms. LM Duration 3 hours.

3.2.- COMPLEMENTARY TESTS:

- Revised 90 Symptoms Questionnaire “SCL-R-90” by Derogatis, 1994, Spanish

adaptation by González de Rivera et al (2002).

- Beck Depression Inventory “BDI”. Spanish adaptation by Vázquez and Sanz

(1997). Department of Personality, Evaluation and Clinical Psychology.
Complutense University of Madrid.

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- State-Trait Anxiety Questionnaire “STAI” by Spielberger, Gorsuch and
Lushene (1982). Adapted to the Spanish population by TEA Ediciones, S, A.

- Factorial Personality Questionnaire “16-PF-5” by Cattell el al. (1995). Adapted

to the Spanish population by TEA Ed., SA

- Minnesota Multiphasic Personality Inventory-2 restructured “MMPI-2-RF” by

Ben-Parath and Tellegen, (2010). Adapted to the Spanish population by TEA
Ediciones, SA

-Leyman psychological harassment strategies questionnaire, LIPT 60, modified

version adapted to Spanish by González de Rivera (2005).

3.3.- DOCUMENTATION EXAMINED:

- Certificate of obtaining the civil servant position through competitive

examination, 1982.

- Public employment offer where a request is made to fill a position with the
same functions as those entrusted to Ms. Martínez, 2005.

- Resolution of the competition corresponding to the offer of public employment,

2007.

- Written by Ms. Martínez, addressed to her hierarchical superior, Mr. Luis

García Ramírez, in which she explains the difficulties she is encountering in her
work in order to carry it out, 2007.

- Report from the occupational doctor ruling out the existence of cardiovascular
disorders in Mrs. Martínez and suggesting the existence of an anxiety crisis as
the etiology of the discomfort experienced, 2008.

- Report on Ms. Martínez issued by the corresponding Primary Care Service

stating that she presents anxiety problems reactive to work problems, initiating
psychopharmacological treatment of anxiolytic type (ieloracepan) and
antidepressant (ie paroxetine), 2008.

- Leave from work due to temporary disability (IT). Reason: Anxious-depressive

syndrome reactive to work problems, 2008.

- Appeal through contentious-administrative proceedings against the resolution

of the competition, 2008.

- Judgment of the Contentious-Administrative Court where the claims of Doña

Luisa are fully estimated, 2009.

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 - Private psychological report stating that Doña Luisa has been undergoing
cognitive-behavioral treatment for 8 months (weekly consultations), having
shown slight improvement to date, 2009.

- Certificate of attendance at therapeutic meeting groups in PRIDICAM

(Platform of the Community of Madrid Against Psychosocial Risks and Labor
Discrimination), where Doña Luisa's involvement is reported as well as an
improvement in this regard, 2009.

- Official document issued by the corresponding Medical Court stating that Ms.
Martínez presents an anxious-depressive condition susceptible to improvement,
2009.

- An interview was requested through burofax with those responsible for

occupational health at the workplace where Ms. Martínez has worked in recent
years. At the time of issuance of this report, no response has been obtained in
this regard.

4.- DESCRIPTIVE ANALYSIS

4.1.- SOCIODEMOGRAPHIC DATA:

AGE: …… years.

DATE OF BIRTH: 00-00-0000.

PROFESSION: Head of international relations for a public organization.

CURRENT SITUATION: Dropped due to IT. Duration 14 months.

Marital status Married.

FAMILY STRUCTURE: She lives with her husband, married for 15 years,
without children. Continuous contact with parents and younger brother.

4.2.- CURRENT SITUATION.

According to the expert's references and through the documentation provided, in

March 2001 she began working, through a civil servant award by competitive
examination, in a public administration center. At the end of 2004, a series of problems
began to occur at work with her superiors and colleagues, according to Ms. Martínez .
The position that the expert had obtained is put up for competition again, granting her
powers, according to what the expert tells us, to another person with less merit and

5
seniority. This situation is experienced by the expert with high anxiety. The anxious
state generated after these problems, referred to by the examinee, causes an anxiety
attack in the workplace that is referenced in the report provided by the occupational
doctor, where he rules out the existence of cardiovascular disorders in Ms. Martínez and
suggests the existence of anxiety crisis in 2008. He then went to the Primary Care
Service, whose report reflected anxiety problems reactive to work problems, and
psychopharmacological treatment of anxiolytic type (ieloracepan) and antidepressant
(ie. paroxetine) in 2008. Since this report, Ms. Martinez has been on sick leave due to
temporary disability due to an anxious-depressive syndrome that is reactive to work
problems, which has lasted until now for a total of 14 months. He is currently
undergoing cognitive-behavioral psychological treatment, lasting 8 months with a slight
improvement, according to the professional's report. She also attends a therapeutic
meeting group at PRIDICAM, in which the report shows improvement in Ms. Martínez.
The report carried out by the Medical Court reveals the presence of an anxious-
depressive condition susceptible to improvement.

4.3.- PSYCHOBIOGRAPHICAL EVALUATION.

The person examined refers to the following data:

Born in 1960, in Madrid, she is the eldest daughter of a family made up of her
parents and two brothers. Nowadays everyone lives and maintains an assiduous
relationship with everyone. She currently lives with her husband, whom she married 5
years ago, and they have no children.

He did not report significant illnesses or significant family history of psychiatric

or psychological treatment.

Describes pleasant memories in childhood and adolescence. Good relationship

with parents and brother. Belonging to a middle class family, with a traditional
educational model, with needs met for affection and protection.

Well adapted outside and inside the school environment, with classmates,
teachers and friends. Adequate social treatment, self-demanding and high academic
performance, studies with scholarships. He has studied a Bachelor's degree in
Environmental Sciences, several Master's degrees and is pursuing a PhD in the absence

6
of a thesis. In addition to this he has studied several languages, English, French and
Italian. He says that he has never had problems in his studies, he has always integrated
well into his group.

He has always lived in Madrid. The relationship with his parents and brother
(and his family, wife and children), has always been satisfactory and with regular
contact with everyone.

With respect to the work environment, she has been involved in the workplace
since 1982, describes pleasure in her work and shows a lot of responsibility in it. He has
changed positions and companies several times depending on the level of demands to
continue growing professionally and educationally. He has worked abroad and all these
jobs always performing positions of great responsibility. To date, he has never had a
sick leave.

He is currently on sick leave due to having an anxious-depressive syndrome

(verified by a psychological report and a report from the Medical Court) with a duration
of 14 months and currently maintained, after the events that occurred in the
aforementioned workplace, and he is currently undergoing psychopharmacological
(loracepan and paroxetine) and psychotherapeutic treatment.

He describes a progressive job dissatisfaction that developed and aggravated

with the termination of his duties and a change of office, leading to him not doing any
work, according to what he says. This situation has caused such a state of anxiety and
isolation that it resulted in an anxiety crisis in the workplace (verified by the
occupational doctor's report).

In the same way, her relationships with her family, husband and friends have
been negatively affected even though they were always adequate.

Currently, the one explored describes anxious-depressive symptomatology, and

identifies the following types of stressors:

1.- Memory of the isolation and the story of the work situation that occurred.

2.- Social isolation after sick leave (husband, friends, family, etc.) she feels like they
don't understand her, she feels misunderstood.

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3.- When he reports that he has stopped doing pleasurable activities such as reading,
walking, etc., due to lack of concentration and strength.

4.- When you think about the future, about the injustice of your situation, about how
everything will end, which shows frustration in this situation.

4.4.- DESCRIPTIVE-FUNCTIONAL ANALYSIS OF CURRENT

SYMPTOMATOLOGY (anxious-depressive state).

-Background:

Psychosocial risk through situations that occur in the workplace such as losing
one's job skills through their assignment to another person, the feeling of isolation when
assigned to a new location, remembering the tense situations experienced. with his
superiors, the fact of carrying out meaningless tasks (completion of reports already
made previously) which leads to a feeling of helplessness or the perception of little
support from his closest circle as well as the deterioration of his marital relationship,
trigger the anxious-depressive responses detailed below.

-Answers

o COGNITIVE RESPONSES: The expert presents cognitive alterations and

internal reasoning, thoughts and self-verbalizations related to the events cited.

- Loss of concentration. “ It is more difficult for me to read .”

- Thoughts focused on the events that occurred “ I didn't know what was
happening to me, I didn't understand why” “Nothing is going to be repaired
or solved .”

- Self-criticism “ At first I thought maybe I had done something wrong.”

- Thoughts of death “ I had no desire to live, a few months ago I wanted to

commit suicide because the doors were closed to me and I thought it was the
best thing, to get out of the way.”

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o BEHAVIORAL RESPONSES: the person examined manifests the following
types of behaviors in the aforementioned situations

- Attempts to avoid interacting with other people " I don't do anything, I don't
go out and since my topic is always on my mind it's a problem ."

- Seeking help from professionals, group therapy.

- Loss of interest in the activities I used to do “ I no longer read or practice

yoga”

- Autolytic attempts “ I was very sad, a few months ago I thought about
committing suicide .”

o PHYSIOLOGICAL RESPONSES

- Nervousness and tachycardia.

- Gastrointestinal disorders.

- Physical problems due to body tension.

- Fluid retention.

- Cavities (medication).

- Weight gain (12 kilos in 14 months).

o EMOTIONAL RESPONSES.
- Feeling of frustration and helplessness “ I didn't understand anything, I
couldn't sleep, I was nervous.” “I thought it wasn't logical or normal,
that they couldn't do whatever they wanted, without impunity.” “My
partner didn't understand me, no one understands me, and my family
doesn't understand me. They have not been able to help me and neither
have my friends, out of incomprehension because they do not understand
anything.”

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 - Feeling of anger: “ I get angry, angry, I am more irascible and I take it
out on my partner when he is around ”
- Hopelessness: “ I wanted to do justice and I find it increasingly difficult
.”
- Feeling of sadness: “ I feel depressed, sad, sick because I didn't
understand anything and because they left me aside .”

-Consequences

Short term:

- Not going to work helps reduce discomfort (ref -).

- Increase in relationship problems (ref -).

- Waiting for legal actions (ref -).

- Secondary victimization (Ref -)

- He receives attention from the people around him, especially family and
friends (ref +).

- Maintenance of therapy (ref+).

Long term:

- Progressive social isolation (notable decrease in leisure and pleasant

activities)

- Manifestations of avoidance contribute to the maintenance of the anxious-

depressive condition.

- Deterioration of marital and family relationship.

- Deterioration of intellectual and work performance.

- Psychophysiological alterations that cause health problems.

4.5 INTERVIEWS CONDUCTED WITH OTHER SOURCES OF

INFORMATION

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 An interview has been requested through burufax with those responsible for
occupational health at the center where Ms. Martinez worked; at the time of issuance of
this report, no response has been obtained in this regard.

4.6 RISK AND/OR VULNERABILITY FACTORS

Following the study of the descriptive analysis carried out on the expert, we
could extract the presence of certain risk and vulnerability factors whose existence may
have increased the probability that the person being examined may have responded in a
maladjusted and pathological manner to the last stressor.

Among the risk factors we can find

 Father heart attack

 Oppositions
 High responsibility and demand in their work functions.

As vulnerability factors we understand those variables that are currently favoring

and maintaining the psychopathological condition presented, among them we would
highlight:

 Personality traits: self-demanding, perfectionist in their work/academic life

 Feelings of responsibility and guilt in the given situation.
 Perception of lack of support from those closest to them.
 Social isolation.
 Confusion at work situation.
 Legal procedure regarding the problem originating from the state.

5. PSYCHOPATHOLOGICAL EXPLORATION.

At the time of the examination, the expert had a low tone of voice and frequent
emotional reactions of sadness when recounting the situation in which she found
herself. He shows a good adjustment to reality characterized by adequate perception,
although his control is destabilized by his mood. Appears conscious, oriented to time,
place and person throughout the evaluation.

11
 Presents himself as approachable at all times, showing his ability and availability
to collaborate and sincerity with the examiner.

Attention-concentration capacity biased by the core of their problem,

appreciating in this aspect a hyperconcentration characterized by excess concentration
on the experience that manifests as a “work problem” (occurring work situation and its
consequences). Referring during the interview to a decrease in their ability to
concentrate during daily life, due to an inability to change the focus of attention.
Furthermore, we can observe during the interview the presence of parasitic memories,
that is, the excessive persistence of the experience that occurred in the workplace, trying
to resist it, although without success since they manifest themselves in an intrusive way.
On the other hand, no sensory-perceptive or emnesic alterations are observed.

Regarding the course and content of thought, we find an adequate course of

thought but a thought content characterized by ruminations (self-reproaches) about the
past negative event focused on the “work problem and what happened” and worries
about future events (anxious worries). ). There are no problems in speech or content.

Normal-high intelligence after clinical assessment.

He also manifests a depressive mood characterized by apathy, anhedonia, and a

continuous state of hopelessness due to the work situation and the legal process in
which he finds himself. This is accompanied by psychophysiological symptoms
characteristic of the anxiety for which the medication is being taken (tachycardia,
anxiety attack).

The expert describes anxious-depressive symptoms reactive to the work situation

experienced and that persists immersed in a legal process and feelings of
incomprehension by people in her family and supports. Perceptible emotional resonance
of suffering and frustration during the evaluation session, in relation to work issues.
These symptoms currently described are: alterations in physiological functions
manifesting a deficit in sleep, weight gain, muscle tension, gastrointestinal problems,
nervousness, headaches and crying. Dysfunction of the ability to concentrate, depressed
mood, anhedonia, hopelessness towards the future. Frequent thoughts about work
problems and their future, frustration that gives rise to irritability and anger. Avoids
social relationships for fear of “others' misunderstanding.” He manifests autolytic

12
intention due to hopelessness, he does not describe toxic habits throughout the
amnanesis, only currently prescribed medication.

He brings to our attention an interference in his social area (few interpersonal

relationships and leisure activities, social isolation), work (sick leave due to reactive
anxious-depressive syndrome) and family (marital problems, perception of lack of
support from family and friends due to lack of understanding of your problem).

To finish, say that they present an emotional insight, understanding objective

reality and maintaining motivation and impetus to improve the situation. For this
reason, he attended psychological and pharmacological treatment from the beginning of
his leave, reporting an improvement in his condition and showing good adherence to
treatment.

6. RESULTS OF COMPLEMENTARY TESTS

The results obtained in the psychometric tests used at the present time are
consistent with the data obtained in the previously developed clinical examination.
These are:

6.1.- Revised 90 Symptoms Questionnaire “SCL-R-90” , by Derogatis, 2002, Spanish

adaptation by González de Rivera et al (2002): Structured scale whose purpose is the
assessment of nine symptomatic dimensions and three global indices of discomfort,
indicates the possible existence of some alteration in the psychological state of the
patient.

The results of the expert examination were the following

SCALES P.S. PC
SOM 0,67 35
OBSESSIVE 0,90 50
INTER RELATIONS 1,22 65
DEPRESSION 1,77 75
ANXIETY 0,90 55
HOSTILITY 0,83 63
PHOBIC ANXIETY 0,71 75

13
 PARANOID IDATION 1,17 65
PSYCHOTICISM 0,60 70
GSI 1,09 70
PSDI 1,69 45
PST 68 90

We could highlight, first of all, that the score obtained on the PST scale (PC=90)
is indicative that Mrs. M manifests a great breadth and diversity of symptoms that she
says she is currently experiencing. In addition, he shows hypersensitivity towards the
opinions and attitudes of others. A score of 75 on the depression scale would indicate
that the patient presents clinical signs and symptoms typical of depressive disorders,
such as dysphoric experiences, feelings of discouragement, anhedonia, and lack of
energy. The phobic anxiety scale, with a centile score of 75, would be indicative that
you have suffered phobic experiences, which have generated avoidant or escape
behaviors more related to social phobia. Regarding the psychoticism scale, the expert
presents a centile score of 70, indicating that she suffers from social alienation. Lastly,
we would highlight the centile score of 63 on the hostility scale, which would indicate a
moderate attitude towards feelings and behaviors of aggressive states. anger, rage and
resentment.

6.2.- State-Trait Anxiety Questionnaire “STAI”, by Spielberger, Gorsuch and

Lushene (2002). Adapted to the Spanish population by TEA Ediciones, S, A. It assesses
the person's current level of anxiety and predisposition to respond to stress.

P.S. PC DEC
A.E. 34 80 7
A.R. 10 4 2

It should be noted that the state anxiety presented by the subject evaluated (that
is, the anxiety corresponding to what he or she feels at the current moment) is high; it is
a transitory condition of the human being that is characterized by subjective feelings of

14
tension and apprehension. , hyperactivity of the autonomic nervous system that could
vary over time and fluctuate in intensity.

6 .3.- Factorial Personality Questionnaire “16-PF-5” , by Cattell el al. (1995).

Adapted to the Spanish population by TEA Ed., SA Its purpose is the appreciation of
sixteen first-order traits and five global dimensions of personality; including three
response measures (social desirability, infrequency and acquiescence)

PRIMARY SCALES

TO b c AN F g h Yo l M N EI Q1 Q2 Q3 Q4
D TH
ER
Dec. 7 6 6 3 6 4 8 3 6 6 4 3 4 5 3 3

GLOBAL DIMENSIONS

ext ans Dur India Auc

(Extraversion) (Anxiety) (Hardness) (Independence) (Self-control)
Decatype 6 2 6 4 2

Validity Scales Decatype

(E) Image Manipulation 6
(IN) Infrequency 9
(AQ) Acquiescence 1

The validity scales denote that it does not present social desirability, which is a profile
characterized by different responses than most people do. Finally, it should be noted
that the responses do not follow an acquiescent model.

Regarding the global dimensions, it should be noted that the expert has low
anxiety, which could mean that she is an adjusted person. He shows low self-control,
which means that he tends to be an uninhibited person, who tends to attend to his own
urgencies by being spontaneous and cheerful, despite this he could have difficulty

15
repressing himself. She could be considered self-indulgent, disorganized, irrepressible,
or irresponsible.

On the other hand, the primary scales reveal a cooperative person, who avoids
conflicts, usually presents himself as a daring and socially confident and enterprising
person, seems to be objective and unsentimental, as well as secure, carefree and
satisfied, so He tends to be flexible and tolerant of order and faults. Lastly, she is
usually confident, placid and patient.

6.4.- Restructured Minnesota Multiphasic Personality Inventory-2 “MMPI-2-RF”,

by Ben-Parath and Tellegen, (2010). Adapted to the Spanish population by TEA
Ediciones, SA

1**3*82”647´0+9-5: F/L´K/

The validity scales denote that the validity would be questionable, indicating
random responses or rejection of errors, possibly the existence of a state of confusion, a
repressive style, observing a tendency to dissimulation.

As for the clinical scales, saying that the HS scale (100hypochondria) would be
related to serious somatic problems, immobilized by a multitude of symptoms and
complaints. The conversion hysteria scale (HY 94) denotes a high suggestibility of
frequent anxiety or panic, the expert reacting to shame by developing physical
symptoms. The SC 82 scale, special sensitive characteristics, it is worth mentioning that
this test underlies a severe clinical depression, the subject evaluated would be seriously
affected by the problems as well as desperate and with feelings of guilt and uselessness,
dejected and slow in thinking and in the acting. Additionally, she shows a high score on
the depression scale (D=80), in which she shows that she is seriously affected by
problems, a state of hopelessness, guilt, and feelings of worthlessness. It should be
noted that the profile obtained with the resulting scores of HS, DY HY, is the profile
that suggests anxious-depressive signs and high intensity, with a tendency to worry
about possible health problems, manifesting graphically the typical inverted V.

The PA 64 scale would lead us to consider a marked interpersonal sensitivity as

well as a tendency to misinterpret the motives or intentions of others, as for PD 72 it
would suggest family problems, the expert would appear impulsive, angry, irritable,
uncooperative, with feelings of guilt and shame. The PF70 scale would be indicative of

16
moderate anxiety, lack of self-confidence, feelings of guilt, perfectionist and indecisive,
not feeling accepted by others. Finally, SI 67 indicates that the person is introverted,
reserved, shy, depressed, with feelings of guilt, lack of self-confidence, submissive,
condescending and responsible at work.

Comparing the scores of the expert with those obtained by victims of harassment
at work in research studies (Gandolfo, 1995 and Mathiesen, 2001, Fig 1), we can only
see differences in the accentuation of the symptoms collected.

120

100

80
SEÑORA MARTINEZ
60 VICTIMA ACOSO LABORAL
(GANDOLFO,1995)
VICTIMA ACOSO MATHIESEN
(2001)
40

20

0
HS D HY PD MF PA PF SC MA SI

Fig 1.- Comparison of the T scores obtained by Mrs. Martinez in the MMPI-2 test with the average T scores
obtained by groups of victims of psychological workplace harassment. Gonzalez-Trijueque, D. Epidemiology,
psychosocial variables and Forensic repercussions. Doctoral Thesis, Madrid, 2007.

6.5.- Leyman psychological harassment strategies questionnaire, LIPT 60, modified

version adapted to Spanish by González de Rivera (2005). Its purpose is the assessment
of psychological harassment strategies at work.

PC
NEAP 99
IGAP 97
IMAP 95

17
 Through the results obtained, we could indicate a wide-ranging perception of
bullying, with the existence of a large number of bullying strategies perceived with
intensity, indicating the degree of global impact of bullying on the subject.

These results show a high probability of the existence of harassment. Comparing

the centile scores obtained by Ms. Martínez with the scores obtained by victims of
workplace harassment and people not harassed at work (Fig2), we can discern a
complete agreement with the results obtained in this questionnaire by victims of
workplace harassment.

120

100

80
SEÑORA MARTINEZ
60 VICTIMA DE ACOSO EN EL
TRABAJO
PERSONA NO ACOSADA EN EL
40 TRABAJO.

20

0
NEAP IGAP IMAP

Fig2: Comparison of the centile scores obtained by Ms. M compared to a sample of victims of workplace
harassment and non-harassed people. LIPT-60. Harassment strategies questionnaire at work. González de
Rivera et al, 2005.

6.6.- Beck Depression Inventory “BDI”. Spanish adaptation by Vázquez and Sanz
(2011). Department of Personality, Evaluation and Clinical Psychology. Complutense
University of Madrid. Its objective is to assess the existence of depressive symptoms as
well as their severity.

The subject obtains a direct score of 12, indicative of mild depression. As a

qualitative assessment in the examination of the expert, we could highlight that the
symptoms detected were the following: considerable decrease in the sensation of
enjoyment (anhedonia), frequent emotional reactions of sadness (crying), lack of
interest in activities that were previously pleasant ( yoga, leisure activities…)

6.7.- DATA INTEGRATION .

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 With the integration of the results we can observe that the symptomatology
described by the expert during the interview, observed in the functional analysis and in
the psychopathological examination, has been consistently and convergently contrasted
in the psychometric examination. The anxiety indicators described are mainly related to
the work situation that occurred and the legal situation in which she has been immersed
since her leave, with symptoms of avoidance and flight from social relationships and
inhibition and discomfort from them, in addition to a feeling of tension and
apprehension (SCL-90-R, STAI tests). Depression indicators are also collected (SCL-
90-R, BDI) and have a global character, with modulating implications in the structure of
personality (MMPI-2), in which we observe concern about somatic symptoms arising
from depression. anxiety, being seriously affected by problems, desperate, feelings of
worthlessness, lack of self-confidence. Although she presents personality traits
characterized by avoidance of conflicts, she is daring and does not show fear in social
situations, objective, utilitarian, carefree, flexible, patient, compatible with the results
obtained through the test (16 PF-5). which is being altered by the symptoms he presents.
He relates this symptomatology to the events that occurred in his workplace, describing
several behaviors precipitating said symptomatology, contrasted through the LIPT-60
test.

7.-CLINICAL JUDGMENT .

After the evaluation carried out and the analysis of the data obtained both in the
psychometric scales and in the symptoms presented during the examination, previously
described, we can say, based on DSM-V criteria (APA, 2013), through the Guide to
Consultation of the Diagnostic Criteria of the DSM-5, of the American Psychiatric
Association, which the expert presents:

F43.23.ADAPTIVE DISORDER WITH MIXED ANXIETY AND DEPRESSIVE

MOOD. [309.28]. Following the diagnostic criteria of the ICD-10, CHRONIC ,
because the symptoms persist for more than 6 months, with Moderate symptoms, in the
advanced Remission phase.

8.-FORENSIC FORMULATION

19
The expert grows up in a normalized psychosocial environment, without being able to
detect any risk factor towards the development of psychopathology in her childhood
(the economic needs have been found covered, as well as an adequate cultural level, the
person examined manifests the absence of any previous psychopathological family
members and significant stressors). She was born and raised in a neighborhood of
Madrid, being the eldest of two brothers, she has good memories of her childhood. She
currently lives with her husband, having been married for 15 years.

Ms. Martinez has a degree in Environmental Sciences, she has always

considered herself a good student. Since she started working, she considers that she has
never had problems in her jobs, she changed jobs on several occasions, the reason for
the change was always because the expert wanted to change her job. He has had several
positions abroad, with a high level of responsibility, speaking different languages
including French, English and a little Italian.

With regard to work, in 1982 she obtained the certificate of obtaining the position of
civil servant through competitive examination and this is where a series of psychosocial
risks begin to occur, these are that years later her skills are again put up for competition,
awarding them to another person. with less merits and seniority according to the expert.
From then on and after speaking with their boss, they proceeded to change Ms.
Martinez's place of work. She began in her new position by not maintaining good
relations with her then current boss, the expert describing that said person yelled at her
on several occasions. She says that they began to ask her for urgent reports that she had
already done previously, putting pressure on her, they isolated her in an office, no one
spoke or interacted with her. As a result of the changes that had occurred, the patient
told us that her head hurt, she could not sleep, she cried easily and on one occasion she
thought she was having a heart attack. For this reason, she went to the work doctor, who
ruled out the diagnosis of a heart attack and recommended that she that she went to her
family doctor who treated her with anxiolytics and antidepressants due to the anxiety-
depressive condition she presented, giving her sick leave for 15 days. The expert says
that these days were not enough, which is why she has currently been on sick leave for
14 months. .

20
 In 2008, the expert appealed the bankruptcy through contentious-administrative
means, in 2009 she obtained the Court's ruling where Ms. Martinez's claims were fully
upheld.

The expert has gone to the psychologist on several occasions over these months, as well
as to PRIDICAM (Platform of the Community of Madrid against Psychosocial Risks
and Workplace Discrimination), from where they informed us of an improvement in the
expert. In 2009, the diagnosis of anxiety-depressive symptoms (issued by the Medical
Court) continued, susceptible to improvement.

21
 LACK OF COPING FEELING OF
PLACE IN LITTLE SOCIAL
STRATEGIES . WORK LOSS.
COMPETITI SUPPORT.
NEW
ON
POSITION
ASSIGNMENT
SOCIAL
ADAPTIVE ISOLATION.
DISORDER WITH
BAD
MIXED ANXIETY
RELATIONSHIP AND
WITH PSYCHOSOCIA MARITAL
DEPRESSIVE
SUPERIORS. L RISK. MOOD PROBLEMS.

CHANGE OF WORK
OFFICE. ISOLATION SECONDARY
PERCEPTION OF PHYSIOLOGICAL VICTIMIZATION.
GUILT. SYMPTOMS.

DETERIORAT
ION OF
HEALTH.
SOCIAL
ISOLATION.

LITTLE JOB
SUPPORT.

22
 9.- FORENSIC DISCUSSION.

9.1.- Current status of Mrs. Martínez.

We can say that throughout the interview the anxiety-depressive symptoms were
collected consistently (clinical interview, psychometric tests, functional analysis,
additional documentation provided by the expert). The recorded symptoms (avoidance,
escape from social relationships, symptoms of apprehension and tension, apathy,
decreased ability to concentrate, insomnia, weight gain, etc.) are identified by the expert
as a response to a major stressor, work situation. occurred, without another stressor
appearing that could explain it. These are clinically significant, producing sick leave (14
months) and a significant deterioration in their social (social isolation), family (marital
problems), personal (insomnia, weight gain), and work (sick leave) areas. In this way
and following the APA (2013) criteria, we can say that it presents an F43.23 Adaptive
disorder with mixed anxiety and depressed mood (309.38) , of a chronic nature ,
since said symptoms last more than six months, with moderate symptoms and in
advanced remission . It should be noted that beyond this damage caused (primary
victimization), we can observe a discomfort derived from the interaction between Ms.
Martínez and the complex legal apparatus in which she has been immersed since the
beginning of the process, that is, since Their skills are up for grabs again. This worsens
and maintains the victim's situation even when the stressor is removed. Numerous
studies highlight (Baca, Echeburúa and Tamarit, 2006; Esbec, 1994; Shapland, 1990)
and show the negative influence that the legal procedure can have on the victims, who
in addition to enduring the damage caused have to demonstrate the existence through a
process long and complex, which I often do not understand and causes uncertainty, in
addition to the reliving of the evils caused (González Trijueque, 2007 TD).

By carrying out a more in-depth study of its symptomatology we can rule out,
through a Differential Analysis , the presence of other disorders that could lead to
confusion due to the possible similarity of the symptomatology, for this we have used
DSM-5 (APA, 2013), being able to say that:

- We ruled out Panic Disorder , since only one panic attack occurred,
according to the expert's references, not meeting Diagnostic Criterion A,
which literally says, “Unforeseen and recurrent panic attacks.”

23
 - Major Depressive Disorder is ruled out as it does not meet all the diagnostic
criteria for this disorder, nor the intensity of the symptoms.
- Regarding Post-Traumatic Stress Disorders and Acute Stress Disorders , we
observe that it does not present Criterion A, which says, “Exposure to death,
serious injury or sexual violence, whether real or threatened, so we rule out
this disorder. That is to say, the stressor is not of the severity, nor of the type
required by criterion A of this type of disorders. The temporal factor must
also be considered, since acute Stress Disorder can only occur between 3
days and one month of exposure to the stressful event.
- Finally, Personality Disorder has been ruled out, since in this case it does not
meet sufficient diagnostic criteria, nor are the traits stable over time, making
it possible to identify the stressor that precipitates the change.

9.2.- Stressful situation identified by Ms. Martínez as a precipitant of said

state.

The stressor identified by Mrs. Martinez as the cause of the symptoms she
presents is the work situation that occurred and described above, agreeing with great
probability with the phenomenon called mobbing. In this sense, we can define mobbing
as a characteristic form of work stress that It has the particularity that it does not occur
exclusively for reasons directly related to work or its organization, but rather has its
origin in the interpersonal relationships established in any organization between
different individuals (Martín-Daza, 1998). In the document on “Raising awareness
about psychological harassment” (2004), the WHO states that mobbing is applied in the
work environment to indicate the aggressive and threatening behavior of one or more
members of a group, the harasser, towards an individual or occasionally towards a
group called target or victim. This situation can manifest itself in various ways and
which follows certain phases of the process of psychological harassment in the
workplace, those proposed by González de Rivera (2003) are: Firstly, the self-
affirmation phase occurs during which Symptoms of anxiety, restlessness and sleep
disturbances predominate. After this first phase, significant confusion begins to develop
in the victim, raising numerous doubts about what is really happening. Subsequently,
the depressive stage appears, in which self-esteem appears significantly impaired, work

24
efficiency is lost, and the process of isolation and avoidance begins. In the fourth phase,
called traumatic, stress and anxiety problems and the presence of obsessive ideas are
evident, and the situation begins to affect the victim's family sphere. Finally, there is the
fifth phase, called chronic stabilization, in which the worker's sick leave is common. In
this case we can find great similarities between the phases proposed by González de
Rivera and the symptomatology process presented by the expert previously developed.

On the other hand, the state presented by the anxious-depressive expert fits with
the usual dynamics of mobbing, since according to the reviewed literature, the clinical
manifestations of a psychological nature shown by workers who are harassed in their
workplace usually revolve fundamentally around the problems of anxiety, therefore, it
should not be surprising that among the most common psychopathological alterations
that victims of mobbing may present are less severe mixed anxious-depressive adaptive
disorders and generalized anxiety disorders and anxious symptomatology of a traumatic
nature in the cases. of special gravity (González – Trijueque and Delgado 2011,
González – Trijueque and Tejero 2011).
Associated with this symptomatology it appears in the reported deterioration at a social,
work, personal, leisure and family level, all of this is related in the bibliography with
said phenomenon, thus we find that according to it, the consequences derived from
workplace harassment can be of a different nature. and project itself onto very varied
areas in the life of the subject who suffers from it (Gonzalez - Trijueque et al 2011).
One of the characteristics of this phenomenon is that the victim perceives the
harassment situation as especially stressful and that it puts both their mental and
physical health at risk.
The most common damages in cases of mobbing occur at the social and personal level
of the harassed worker, the latter in the form of physical complaints and psychological
discomfort. The social sphere is affected both inside and outside the work environment
because it promotes social relationships to a lesser extent or because these relationships
distance themselves from someone who regularly talks about their problems at work and
how misunderstood they feel, promoting isolating behaviors that do not they contribute
but rather aggravate their situation (González-Trijueque et al 2011). If the expert's
psychological situation persists over time without a solution, it could lead to more
serious pathologies, potentially producing persistent personality alterations (Leymann,
1996; González-Trijueque, 2007), since victims of mobbing, even after After expulsion

25
from the organization, the effects can continue to manifest and even intensify
(González-Trijueque, 2007).

9.3.- Causality and Simulation.

After all of the above, we can say that the symptomatology found of an anxious-
depressive nature is derived from a stressful event (work problem) and causes clinically
significant discomfort and deterioration in the social, work, and personal aspects of the
expert, pointing out that after the interview we can find that the harassing behavior
described corresponds with the technical definitions of the concept of mobbing in terms
of the characteristics found in the literature, constituting the main stressor and by itself
is sufficient to produce the described pathology, without finding other vulnerability
factors than the explain. State that we can discard the simulation , since it could only
meet the criterion of an external incentive indicator. In this case we can see that the
simulation indicators proposed by González de Rivera and López-García, 2003 do not
exist, since: 1) the psychopathological picture expressed fits with the usual dynamics of
the alteration; 2) the expert shows inability to work and inability to leisure; 3) it does
not avoid a specialized assessment; 4) does not show disparity between psychometric
tests; 5) shows collaboration throughout the exploration, providing all information
requested; 6) no traces of immaturity, nor indicators of lack of honesty or greed are
detected in the expert; 7) no obvious inconsistencies are found in the symptoms
presented by Mrs. M; 8) does not have an unfavorable professional career, absenteeism,
poor performance. Thus we can say that the pattern of symptoms is presented
consistently throughout the evaluation process in all the evaluation instruments used,
both qualitative and quantitative, and their validity scales reveal the reliability of the
results.

9.4.- Treatment and Prognosis .

At present, he has good adherence to treatment, characterized by constant collaboration

throughout the evaluation process and the treatment process since, as we mentioned
above, he maintains his pharmacological treatment (anxiolytics and antidepressants) and
continues to attend group therapy. in order to improve their condition. This attitude, as
he tells us, has been a trend since the beginning of the sick leave. The results show the
improvement in Ms. Martínez's condition, feeling calmer and more relaxed as she says

26
in the interview. Probably even if we find ourselves with a chronic disorder, the
symptoms are moderate and in advanced remission, and a remission of this may occur,
since it presents an absence of previous pathologies and adherence to treatment. This
treatment helps them recover the level of functioning they had before the disorder began
(work, social, leisure, personal, family), managing to adapt to the situation and
providing a safe context in which to face adverse situations and learn to cope with them.
If, on the other hand, the stressor or consequences persist, it could trigger the
appearance of more serious mood disorders such as depression.

Finally, as we have mentioned previously, it is worth noting that and no less

evident, in addition to the clinical picture presented by the previously described
adaptive disorder, the existence of direct consequences of these and that help to
aggravate and maintain the symptoms in Ms. Martínez. Thus we can observe the
existence of the legal situation with the company where said harassment situation
occurred (secondary victimization), the decrease in social and family relationships,
rewarding leisure activities and the deterioration in physical health that maintains the
instability and the inadaptation of the examined person to his environment from the
beginning of said symptoms, therefore interfering in the psychological integrity and
health of the expert.

10.- BIBLIOGRAPHICAL REFERENCES.

- Arcides, J. and Puentes, A. (2010). Personality traits and self-esteem in victims of

workplace bullying. Divers: Psychological Perspective, 6 (1), 51-64.

- American Psychiatric Association. (2013). Reference guide to the DSM-5 diagnostic

criteria. Arlington, VA American Psychiatric Association.

- Beck, Aaron. T. (2005). Beck Depression Inventory (BDI), SI FoesFarma.

- Claudia Peralta, M. (2004). Workplace Harassment-Mobbing-Psychological

Perspective. Journal of Social Studies, 18, 111-122.

- Derogatis, Leonar R. (2002). SCL-90-R. 90 Symptoms Questionnaire. Madrid: TEA

Editions.

27
- González de Rivera, L. (2003). Psychological bullying strategies questionnaire: The
LIPT-60. Psychiatric Magazine , 32, 18-28.

- González de Rivera, JL and López-García, JA (2003). The legal medical assessment of

moobing or workplace harassment . Psyche: Journal of Psychiatry, Psychology and
Psychosomatics , 24 (3), 5-12.

- González de Rivera y Revuelta, JL, Rodríguez Aburín. (2005). LIPT-60: Harassment

Strategies at Work Questionnaire. Madrid: EOS.

- González-Trijueque, D. (2007). Psychological harassment in the workplace:

epidemiology, psychosocial variables and forensic repercussions. Doctoral Thesis. Dir.:
Prof. Dr. José Luis Graña Gómez. Faculty of Psychology. Complutense University of
Madrid.

- González-Trijueque, D. (2012). Expert assessment of psychological harassment in the

workplace: mobbing. Teaching Manual of Clinical Legal and Forensic Psychology, 2
(2), 295-311.

- González-Trijueque, D. and Delgado Marina, S. (2011). Mobbing in Spanish and Latin

American workers: an exploratory study with the LIPT-60. PRAXIS. Journal of
Psychology, Vol.19, 31-51.

- González-Trijueque, D. and Delgado Marina, S. (2011). Methodological proposal for

the expert evaluation of the victim of mobbing.Clinical, legal and forensic
psychopathology, Vol. 11, 133-166.

- González-Trijueque, D. and Graña Gómez, JL (2009). Psychological harassment in the

workplace, prevalence and descriptive analysis in an occupational sample.
Psychothema, 21(2), 288-293.

- González-Trijueque and D, Tejero, R. (2011) Mobbing or psychological harassment in

the workplace. Conceptual delimitation and forensic implications. Treaty of Legal
Medicine and Forensic Sciences, Vol. 2. Barcelona: Bosch.

- López-Cabarcos, MA; Vázquez Rodriguez, P. and Montes Piñeiro, C. (2010).

Mobbing: Psychosocial antecedents and consequences on job satisfaction. Latin
American Journal of Psychology, 42 (2), 215-224.

- Luna, A. (2003). Psychological Harassment at work (mobbing) Secretary of

Occupational Health. Madrid: Pyramid.

- Martín-Daza, F., Pérez-Bilbao, J. and López, A. (1998) NTP 476. Psychological

harassment at work: Mobbing. Madrid: National Institute of Safety and Hygiene at
Work.

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 -NTP. Psychological harassment at work . Recovered from
http://www.insht.es/InshtWeb/Contenidos/Documentacion/FichasTecnicas/NTP/
Ficheros/821a921/854%20web.pdf

-Nichols, David. S. (2002). Keys for evaluation with the MMPI-2. Madrid: TEA
Editions.

- Ovejero Bernal, A. (2006) Mobbing or psychological harassment at work: A

psychosocial perspective. Journal of Work and Organizational Psychology, 22 (1) 101-
121.

- Russell, Mary T, Karol, D.L. (2005). 16-PF-5. Madrid: TEA Editions.

- Spielberger, C.D. (2002). State Trait Anxiety Questionnaire (STAI): Manual/CD

Madrid: TEA Editions.

11.- CONCLUSIONS.

The signing experts have drafted the content of this report impartially and in
accordance with the best of their knowledge and belief and based on the examination
carried out and the documentation presented by the expert, we issue the following
conclusions:

FIRST . The patient examined presents characteristic symptoms of

F43.23.ADAPTIVE DISORDER WITH MIXED ANXIETY AND DEPRESSIVE MOOD.
[309.28]. Following the diagnostic criteria of the ICD-10, CHRONIC , because the
symptoms persist for more than 6 months, of moderate intensity, in advanced remission.

SECOND . The stressor identified by Ms. Martínez as the cause of the

symptoms she presents is the work situation that occurred, which most likely coincides
with a situation of workplace harassment.

THIRD. The existence of psychopathology motivated the situation of sick leave

and the beginning of pharmacological and psychotherapeutic treatment that lasts 14
months and continues today. At the time of the examination, his symptoms improved
but he continued to present significant limitations in different areas: social, family,
personal, and work.

29
 QUARTER. The symptoms and limitations that persist in the life of the person
being examined require the maintenance of supervision and psychotherapeutic
treatment, so that the symptoms do not evolve into a more serious pathology.

As soon as we report,

In Madrid to…. from December to ….

Signed: Mrs. Cristina García Martínez, Licensed Psychologist No.…….

30