Concept Map 1Mary 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?
(Concept maps are visual representations of information. They can be charts, graphic organizers, tables, flowcharts, Venn Diagrams, timelines, or T-charts. )
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Main diagnosis: Conduct disorder
Key symptoms:
1. Initiates fights with classmates and enjoys intimidating them.
2. Takes and destroys others’ possessions for fun.
3. Engages in risky behavior such as riding her bicycle outside the neighborhood without permission.
4. Lying to her parents about her whereabouts and seeming unconcerned about their worry.
Differential diagnoses considered:
1. Oppositional defiant disorder (ODD): While ODD shares some symptoms with conduct disorder, Mary Rose's behavior goes beyond the typical defiance seen in ODD. Her enjoyment in intimidating others and destructive behavior suggests a more severe diagnosis.
2. Attention-deficit/hyperactivity disorder (ADHD): Although Mary Rose's behavior includes impulsivity and risk-taking, her intentional intimidation of others and destructive behavior are not typical symptoms of ADHD.
Treatment recommendation:
1. Psychotherapy: Mary Rose should be referred for individual therapy to address her behavioral issues, develop healthier coping mechanisms, and work through trauma from her past experiences.
2. Family therapy: Including Mary Rose's adoptive parents in therapy can help improve communication, set consistent boundaries, and develop strategies for addressing her behavior effectively.
3. Supportive services: Collaboration with school personnel and referral to support services such as school counseling or behavioral intervention programs can aid in managing her behavior in the school setting.
Prognosis:
With appropriate therapeutic intervention, it is possible for Mary Rose to learn healthier ways of relating to others and managing her emotions. However, the prognosis may depend on the severity of the underlying trauma she experienced and the level of support and consistency in her environment. Ongoing monitoring and support will be crucial for her long-term well-being.
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