Week 6 discussion response to classmates | Psychology homework help

Case Conceptualization:

Andrew is a 15-year-old Caucasian male who has recently been expelled from school after a physical altercation with another student and threatening to kill them. Andrew was found with a small knife in his possession and taken into custody, where he was later released to an intensive treatment center for a psychiatric assessment. Andrew is often getting is physical altercations with his peers and is said to have very few, if any, real friends. Many of the people he hangs out with are known for possessing drugs, getting into fights, and illegal behaviors. These behaviors became apparent when Andrew was in late elementary to early middle school, where he became aggressive, and started cheating, stealing, fighting, and sniffing substances. At the age of 11, he was court ordered to a residential treatment center after assaulting a girl at school. Andrews parents are known to be neglectful. His father works two jobs, day shift and night shift, while his mother works night shift at a local gas station 5 days a week. On their off time, they want nothing to do with their five children. Andrew is often responsible for taking care of his younger siblings which makes him angry and resentful. When Andrews father is not working, he drinks so heavily that he becomes aggressive, usually targeting Andrew and his mother with abuse. Andrews mother has been involved in his inpatient therapy and expresses that as a child, Andrew would often catch animals and severely hurt or murder them. She said that he showed zero emotion while doing so and that the animals got larger as he grew older. His symptoms date back to around age six.

Diagnostic Impressions:

F91.1 Conduct Disorder, Childhood-Onset Type with Limited Prosocial Emotions, Severe.

Rational for Diagnostic Impressions:

Based on case presentation, Andrew appears to be demonstrating symptoms consistent with F91.1 Conduct Disorder. Andrew meets eight of the fifteen criteria for this disorder, only three are required. Criteria met includes threatening others (A1), initiating physical fights (A2), used a knife in a physical altercation (A3), has been physically cruel to people (A4) and animals (A5), forced sexual activity at age 11 with a girl at school (A7), Stealing without confrontation (A12), truancy at school (A15), and impairment in social and academic functioning (B) (American Psychiatric Association, 2013). In the last 12 months, Andrew demonstrated at least five of these criteria including criterion A1, A2, A3, A4 and A15. Andrew’s mother shared that she witnessed him emotionlessly catching and killing frogs at age 6 and moving on to larger animals as he grew older. This indicated a childhood-onset type where individuals show at least one symptom of the disorder before the age of 10 (American Psychiatric Association, 2013). Andrew also displays two of the specifying factors of limited prosocial emotions. He expresses lack of remorse or guilt for his actions against others and animals, this includes his most previous altercation of threatening another student’s life. He also expresses a lack of empathy which can be seen in his disregard for the feelings of those he harms. He also meets this specifier by being more concerned about himself when it comes to the care of his four younger siblings. Andrews condition would be considered severe because he meets the majority of the criteria presented and has exhibited forced sexual activity, physical cruelty, and use of a weapon (American Psychiatric Association, 2013). Andrew’s severity with aggression evolved very quickly, as seen in his disruptive behaviors of sexual assault, physical assault, attack with weapons, and murder (of animals) before late adolescence (Playo, 2018). Because childhood-onset types typically experience a worsening of symptoms as they enter adulthood, Andrew may exhibit comorbidity for F60.2 Antisocial Personality Disorder as he reached age 18 (American Psychiatric Association, 2013). He also shows many if not all of the symptoms for F91.3 Oppositional Defiant Disorder, but differs because his symptoms are of a more severe nature and include aggression towards people and animals (American Psychiatric Association, 2013).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. Paylo, V.E.K.M. J. (2018). Treating Those with Mental Disorders. [VitalSource Bookshelf]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780134802893/