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CASE STUDY #8- JEREMY DIAGNOSIS Based on the information given in the situation of Jeremy, there are two possible diagnoses. First is Conduct Disorder and the second is the Oppositional Defiant Disorder. While both disorders are described by the presence of a negative pattern in actions performed by a person, they are different in the aspect that in oppositional defiant disorder, the offensive behavior of the person does not cause substantial harm to others or involve breaking important rules in the society where he belongs.
According to the DSM-IV-TR, a conduct disorder diagnosis is made when the child goes against the rules, age-appropriate social customs, and the rights of others in a period of at least twelve months (Encyclopedia of Mental Disorders). Jeremy has had problems since nursery school, making it hard difficult to deal with him. He is now 9 years old, and with still the same problems in behavior. This is manifested by three or more of the following actions, with at least one having occurred in the past six months.
The first is aggression to humans or animals, which evidently, Jeremy has done. There have been situations of him teasing and kicking other children and annoying them on purpose. Also, he has been involved in fights, although only minor ones. He also swore at his teacher a few weeks before consultation, resulting in his suspension from school. Second behavior is property destruction, which Jeremy displayed on two occasions, first when he broke the window with his friend, and second when he crashed his bike into a store window because he didn't apply the pedal brakes.
Third is lying or theft, applicable also to the case of Jeremy because according to his mother, Jeremy tells minor lies to her. The last behavior expected to manifest in someone with a conduct disorder is serious rule violation like riding his bike on the street even though his mother had strictly imposed this rule to him many times over. Jeremy's action resulted in his receiving a warning from the police. This happened a week before Jeremy's mother decided to bring him for evaluation at a mental health clinic.
Evidently, Jeremy's case is one of a Conduct Disorder rather than an Oppositional Defiant Disorder. He has clearly caused harm to others and went against rules of his mother, and of the society. A similar disorder to Conduct Disorder is Anti-social Personality Disorder. In this type of disorder, however, the person begins to show a persistent pattern of rights violation at the age of 15. Since Jeremy is only 9 years old, then this disorder is clearly not among the options.TREATMENT The treatment of Conduct Disorder is mainly based on the developmental age of the child.
However, the basic treatment usually involves having the child face the consequences of his actions (Toy & Klamen, 2004). For school-age children, the group where Jeremy belongs, the focus of treatment is directed on the child, his family, and his school environment. This includes parental education, social skills guidance, and increase the capability of the child to conform to rules and orders of authority figures. Family therapy is also considered vital for treating school-age children with Conduct Disorder.
This type of therapy aims to teach the parents of the child how to successfully relate rules of behavior in dealing with their child as well as how to teach and train the child in using new skills. Pharmacologic interventions, although of little value, may be given in the event that the child displays symptoms such as aggression that might end up harming others or even himself (Videbeck, 2006). Toy, E. C. & Klame, D. L. (2004). CASE FILES Psychiatry. United States of America: McGraw-Hill Companies Inc.
Videbeck, S. L. (2006). Psychiatric Mental Health Nursing 3rd Ed. United States of America. Lippincott Williams & Wilkins.Conduct Disorder. In Encyclopedia of Mental Disorders. Retrieved December 2, 2009, from http://www.minddisorders.com/Br-Del/Conduct-disorder.html
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