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Jan 9, 2024





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1 The Case Study of Michael Kelsey Dye Adult School of Behavioral Science and Development Mid-America Christian University COUN 6733: Child/Adolescent Psychopathology and Counseling Dr. Kendra Stewart-Nelson March 17, 2023
2 The Case Study of Michael This case study involves Michael, who is an eight-year-old boy. Michael lives with his mother, grandmother, and brother in Los Angeles, California; and recently transferred to Hillswood School. Michael transferred to his new school due to expulsion from his previous school, John Ritter Elementary, for misconduct. Since his transfer to his new school, he has experienced many issues, which may affect his performance by receiving low marks on assignments, tests, and progress report cards. To appropriately diagnose Michael, I will provide a case study analysis, explore key symptoms through the DMS-5 Handbook of Differential Diagnosis, identify differential diagnosis criteria, provide a final diagnosis, and defend the diagnosis. Case Study Analysis I will provide information regarding Michael's behaviors, emotions, awareness, relationships, and developmental stage characteristics for analysis. Michael's behaviors and emotions are sometimes contradictory. Michael is characterized as being an enthusiastic, energetic, and talkative child. In addition, he is also disruptive, fidgety, socially impaired, argumentative, unable to maintain friendships, disrespectful, loses his temper, frustrated, quiet, and shy; and copes with difficult feelings by hitting his head with his hands, slamming down his pencil, and shutting down. Michael's cognitive ability is not fully explored during the case study, and there may be some cultural issues that reflect poor grades since he is Hispanic/Latino and speaks both English and Spanish. The case study states he receives C's in math and D's and F's in all other subjects, which require reading and comprehension skills. As a result, Michael receives supplemental
3 reading instructions twice per week. Michael does not receive any additional special services from Hillswood. Michael's relationships seem to be affected at his new school. Michael states he does not get along with the new children but claims he misses his friends at his old school. Michael understands that he struggles socially at Hillswood. The difficulty with his relationships at Hillswood is observed through Michael's statements, the teacher's statements, and his behaviors. Michael’s Stage of Psychosocial Development, according to Erikson, should be the fourth stage, the Industry vs. Inferiority stage. During this stage, Michael should learn how to begin to do things independently; and prioritize friendships, which should result in increased self-esteem. If Michael appropriately meets this stage by the reinforcement of others, he can reduce inferior feelings. However, Michael may not have appropriately met this stage of development due to limited peer engagement (Mcleod, 2023). Key Symptoms The DSM-5 Handbook of Differential Diagnosis decision tree for behavioral problems in a child or adolescent will help identify a possible diagnosis for Michael. Michael’s symptoms are not associated with substance use; not due to the physiological effects of a medical condition; he does not have severe temper outbursts that are out of proportion to the situation; Michael does experience patterns of persistent hyperactivity, impulsivity, and inattention; and his symptoms occur in at least two different situations, and causes clinically significant impairment which presents before the age of twelve. As a result, a valid diagnosis for Michael is attention-deficit/hyperactivity disorder (3.1.4) (First, 2014). Differential Diagnosis Criteria
4 The differential diagnoses for attention-deficit/hyperactivity disorder include oppositional defiant disorder, intermittent explosive disorder, conduct disorder, stereotypic movement disorder, specific learning disorder, intellectual disability, autism spectrum disorder, disinhibited social engagement disorder, disruptive mood dysregulation disorder, anxiety disorder, major depressive disorder; bipolar I and bipolar II disorder; borderline, antisocial, and narcissistic personality disorder; and neurocognitive disorders (First, 2014). Michael cannot be diagnosed with oppositional defiant disorder because he is not resistant to school tasks or work. He cannot be diagnosed with intermittent explosive disorder because he does not present with serious aggression toward others. Michael cannot be diagnosed with conduct disorder because he does not have high levels of impulsivity. He cannot be diagnosed with stereotypic movement disorder because his movements are not generally fixed and repetitive. Michael cannot be diagnosed with a specific learning disorder because his life is impaired outside of school work. He cannot be diagnosed with an intellectual disability because he has symptoms outside of tasks in school. Michael cannot be diagnosed with autism spectrum disorder because his social disengagement is not due to deficits in social communication and his inability to tolerate change. He cannot be diagnosed with disinhibited social engagement disorder because there is no history of insufficient care. Michael cannot be diagnosed with disruptive mood dysregulation disorder because he does not present with pervasive irritability and intolerance of frustration. He cannot be diagnosed with an anxiety disorder because his inattention is not due to fear, worry, or rumination. Michael cannot be diagnosed with major depressive disorder because his inability to concentrate is not during a major depressive episode. He cannot be diagnosed with bipolar I or bipolar II disorder because his symptoms are not episodic. Michael cannot be diagnosed with borderline, antisocial, or narcissistic personality
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