Mr. and Mrs. Lawson brought their 4-year-old adopted daughter, Clara, to see Dr. Mason, a psychiatrist. Clara was polite in greeting Dr. Mason, but did not smile and kept her gaze down as she took a seat. Mr. and Mrs. Lawson sat next to Clara and began explaining their concerns. They described Clara as a quiet child who has recently begun throwing temper tantrums, during which she is inconsolable. Her sleep and eating patterns have changed, and she no longer wants to go to preschool.
• Create a 150 to 200-word response to each of the following questions:
o What other information would you like to learn during the interview with the family? What questions would you ask?
o In addition to the clinical interview, what other types of assessments would you utilize? What would you hope to learn with each type of assessment?
o If you were preparing to diagnose Clara, you would refer to the DSM-IV classification system to evaluate her condition on five separate axes.
What TYPE of information would go into each axis? (You are not asked to suggest information that is specific to Clara…only to describe the kind of information that would be entered in each axis.)
o Do you think that diagnosing Clara would be beneficial or harmful? Explain why.
What is your question?
But, please be advised that it's totally irresponsible to even attempt a diagnosis on the basis of one short paragraph.
Wha is your question?
All hail Thomas Wang
Q1: What other information would you like to learn during the interview with the family? What questions would you ask?
During the interview with the family, it would be helpful to gather more information about Clara's background and any potential triggers or events that may have contributed to her recent behavioral changes. Some questions that could be asked to gain a better understanding are:
1. Can you provide some more information about Clara's early life before adoption?
2. Have there been any recent changes or stressful events in your family?
3. How does Clara interact with other children her age?
4. Has Clara experienced any significant losses or changes in her life recently?
5. How is Clara's overall mood and behavior outside of the temper tantrums?
Q2: In addition to the clinical interview, what other types of assessments would you utilize? What would you hope to learn with each type of assessment?
In addition to the clinical interview, other types of assessments that could be used include:
1. Observational Assessment: Observing Clara's behavior in different settings, such as at preschool or during playtime, can provide valuable insights into her interactions, social skills, and emotional regulation.
2. Behavior Rating Scales: These standardized questionnaires could be given to both the parents and teachers to provide a more comprehensive understanding of Clara's behavior across different contexts.
3. Psychological Testing: This could include cognitive assessments to evaluate Clara's intellectual functioning, as well as emotional and behavioral assessments to assess her emotional development and identify any potential underlying issues contributing to her temper tantrums.
Q3: The DSM-IV classification system uses a multi-axial approach to evaluate an individual's condition on five separate axes. Each axis is designed to capture different aspects of the individual's functioning. The types of information that would typically go into each axis are as follows:
1. Axis I: Clinical Disorders and Other Conditions That May Be a Focus of Clinical Attention - This axis includes any diagnosable mental disorders or clinical conditions that are currently present, such as anxiety disorders, depressive disorders, or attention-deficit/hyperactivity disorder (ADHD).
2. Axis II: Personality Disorders and Mental Retardation - This axis captures any enduring patterns of behavior and traits that affect overall functioning, such as personality disorders or intellectual disability.
3. Axis III: General Medical Conditions - This axis lists any relevant medical conditions or physical health issues that might be influencing or co-occurring with the mental health symptoms being evaluated.
4. Axis IV: Psychosocial and Environmental Problems - This axis includes any significant psychosocial or environmental stressors, such as school difficulties, family problems, or recent life events that may be contributing to the individual's symptoms.
5. Axis V: Global Assessment of Functioning (GAF) Scale - This axis provides an overall rating of the individual's level of functioning, taking into account both psychological and social factors. It ranges from 0-100 and helps clinicians to assess the individual's overall impairment and ability to function in daily life.
Q4: Diagnosing Clara could be beneficial if it leads to appropriate treatment and support for her. A diagnosis provides a framework for understanding her symptoms, helps guide treatment decisions, and may allow her and her family access to necessary resources and support services. It can also help to validate the experiences of the family and potentially reduce feelings of uncertainty or blame.
However, it's essential to consider the potential harmful aspects of diagnosis as well. Diagnosing a young child like Clara must be done with caution, as it can possibly stigmatize her, limit her opportunities, and create a self-fulfilling prophecy or overly medicalize her experiences. Therefore, it is crucial to ensure that the diagnostic process is conducted ethically, with a focus on understanding and supporting Clara's well-being rather than merely labeling her. The primary goal should be to use the diagnostic information to guide appropriate interventions and provide the necessary support for Clara and her family.