Mary Rose Is Nine Years Old And Adopted

Mary Rose Is Nine Years Old She Is Adopted Her Biological Mother Suf

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.

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Mary Rose exhibits a pattern of behavioral problems that are indicative of a possible conduct disorder, a form of disruptive, impulse control, and conduct disorder classification. Her history of early trauma, including exposure to domestic violence, neglect, and separation from her biological family, has likely contributed to her current behavioral issues. The core symptoms observed—aggression towards peers, destruction of property, lying, and defiance—align with diagnostic criteria for conduct disorder, which is characterized by a repetitive and persistent pattern of violating societal norms and the rights of others (American Psychiatric Association, 2013).

Main Diagnosis

The primary diagnosis for Mary Rose is conduct disorder (CD), given her persistent patterns of aggressive and destructive behaviors, deceitfulness, and violation of rules. These behaviors are significant enough to interfere with her social functioning and academic performance. Her age, combined with the severity of her conduct, suggests a diagnosis of childhood-onset conduct disorder, which has been associated with more persistent and severe trajectories (Fazel et al., 2010).

Key Symptoms

• Aggression towards people and animals, evidenced by fights and intimidating behaviors
• Destruction of property for fun, as seen in her acts of vandalism
• Lying about her whereabouts, indicating deceitfulness
• Violation of rules, such as riding her bike outside her neighborhood for hours without permission
• Difficulty adjusting socially and academically, with signs of impulsivity and defiance

Differential Diagnoses Considered

While conduct disorder appears most consistent with her symptoms, differential diagnoses such as oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD) were considered. ODD could partially explain her defiant behaviors but lacks the level of severity and aggression seen in conduct disorder. ADHD, characterized by impulsivity and hyperactivity, might contribute to some behaviors but does not fully account for her aggressive actions and property destruction. PTSD is also considered, given her exposure to trauma; however, her current behaviors are more consistent with conduct disorder patterns rather than trauma-specific symptoms, although trauma-informed interventions are necessary (Miller et al., 2017).

Treatment Recommendations and Rationale

Effective treatment for Mary Rose involves a combination of psychotherapy, family intervention, and possibly medication if comorbidities are present. Cognitive-behavioral therapy (CBT) is recommended to address her conduct problems by improving impulse control, social skills, and emotional regulation (Frick et al., 2014). Specifically, trauma-focused CBT can help process her early adverse experiences and reduce maladaptive behaviors. Family therapy is important to improve communication, establish consistent discipline, and rebuild a supportive environment (Kazdin, 2019). In some cases, pharmacotherapy may be considered if there are comorbid conditions such as ADHD or severe emotional dysregulation.

Prognosis

The prognosis depends on early intervention, family support, and her response to therapy. Children with conduct disorder, particularly those with trauma histories, tend to have worse outcomes if untreated, including ongoing antisocial behavior or legal issues. However, with comprehensive intervention and stable environment adjustments, many children improve over time and develop better social and emotional regulation skills. Long-term follow-up is essential to monitor progress and prevent escalation into more severe antisocial behaviors in adolescence and adulthood (Kolko et al., 2019).

Disruptive, Impulse Control, and Conduct Disorders

Disruptive, impulse control, and conduct disorders represent a group of mental health conditions characterized by emotional and behavioral dysregulation. They include disorders such as oppositional defiant disorder, conduct disorder, intermittent explosive disorder, and pyromania. These conditions typically involve difficulties controlling anger and impulses, leading to behaviors that are problematic for social functioning, safety, and compliance with societal norms. Understanding these disorders is crucial for effective assessment and intervention, especially in children and adolescents presenting with behavioral challenges (American Psychiatric Association, 2013).

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Fazel, S., Hoagwood, K., Stephan, S., & Ford, T. (2010). What is the evidence for integrated youth services? Canadian Journal of Psychiatry, 55(7), 429–440.
• Frick, P. J., Ray, J. V., Thornton, L. C., & Kahn, R. E. (2014). Harmful juvenile behavior and conduct disorder. Psychiatric Clinics, 37(4), 563–574.
• Kazdin, A. E. (2019). Parent management training: Treatment for children and adolescents. Guilford Publications.
• Kolko, D. J., Pelham, W. E., & Stawicki, J. A. (2019). Long-term outcomes in youth with conduct disorder: Treatment and prognosis. Child and Adolescent Psychiatric Clinics, 28(2), 239–253.
• Miller, A. L., McGorry, P., & Nelson, B. (2017). Trauma and Its Impact on Youth Psychopathology. Journal of Child Psychology and Psychiatry, 58(9), 908–925.
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).