Posted: June 14th, 2023

Pscyh Discussion. Mary Rose is nine years old

Pscyh Discussion. Mary Rose is nine years old. She is adopted. Her biological mother suffered from depression and her biological father was abusive. Mary Rose was removed from the home at age three, but not before witnessing excessive arguing between her parents, including physical fighting. Mary Rose spent time in foster care before being adopted three years ago. She has had difficulty adjusting to her new family and school. She initiates fights with her classmates and seems to enjoy intimidating them. She takes others’ possessions and destroys them just for fun. Last week she rode her bicycle outside of her neighborhood and was gone for three hours. She lied to her parents about where she had been and couldn’t understand why they were worried about her.

Concept Map Information

What is the Main diagnosis for Mary Rose?
What are the Key symptoms?
What differential diagnoses did you consider and why?
What is your treatment recommendation and why?
What is the Prognosis?

What are Disruptive, Impulse Control, and Conduct Disorders?

https://www.psychiatry.org/patients-families/disruptive-impulse-control-and-conduct-disorders/what-are-disruptive-impulse-control-and-conduct-disorders

Disruptive, impulse control, and conduct disorders

https://youtu.be/XH46Nm1QOcg

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Based on the provided information, the main diagnosis for Mary Rose could be Conduct Disorder.

Key symptoms:

Initiating fights with classmates and enjoying intimidating them.
Taking others’ possessions and destroying them for fun.
Lying to her parents about her whereabouts and not understanding their concern.
Differential diagnoses that could be considered include:

Oppositional Defiant Disorder (ODD): This disorder is characterized by a pattern of defiant and disobedient behavior towards authority figures, but it does not typically involve aggression towards others or the destruction of property. Mary Rose’s behavior seems to extend beyond the criteria for ODD.

Attention-Deficit/Hyperactivity Disorder (ADHD): While ADHD can contribute to impulsivity and difficulty with self-control, Mary Rose’s behavior appears to be more purposeful and deliberate rather than driven by inattention or hyperactivity alone.

Posttraumatic Stress Disorder (PTSD): Mary Rose’s history of witnessing excessive arguing and physical fighting between her biological parents, as well as her removal from the home, could potentially contribute to symptoms of PTSD. However, her behaviors seem to go beyond what is typically seen in PTSD, particularly in terms of her aggressive and destructive tendencies.

Treatment recommendation:
Given the severity and persistence of Mary Rose’s behaviors, it would be advisable to involve a mental health professional for a comprehensive evaluation and treatment plan. A multimodal approach may be recommended, including:

Individual therapy: Psychotherapy can help Mary Rose explore and process her experiences, develop coping strategies, and improve her emotional regulation and social skills.

Family therapy: Involving the adoptive family in therapy can address any family dynamics, improve communication, and provide support and guidance for managing Mary Rose’s behavior.

School intervention: Collaboration with the school, such as involving the school counselor or psychologist, can help address any academic or social difficulties, provide behavioral interventions, and support Mary Rose’s adjustment in the school setting.

Prognosis:
The prognosis for Mary Rose depends on various factors, including the severity and chronicity of her conduct issues, the availability of appropriate treatment and support, and the stability and nurturing environment provided by her adoptive family. Early intervention and a comprehensive treatment approach can significantly improve her prognosis and increase the likelihood of positive outcomes. However, long-term monitoring and support may be necessary to address any ongoing challenges and promote healthy development.