Child and Adolescent Psychopathology: Diagnosis, Interventions, and Considerations for Pharmacotherapy

This article discusses child and adolescent psychopathology, including the diagnosis and interventions for aggressive and self-destructive behavior. It emphasizes the importance of understanding family background and history in providing effective treatment. The article also explores considerations for pharmacotherapy interventions and potential side effects of suggested therapies and medications.

Child and Adolescent
Psychopathology

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
1. Differential diagnosis for choice of hypothesis to Martin as per the main reason of his
behaviour.....................................................................................................................................3
2. Further diagnosis and milestones.............................................................................................4
3. Interventions............................................................................................................................6
4 1 Considerations need to be taken when considering pharma-therapeutic interventions to
children........................................................................................................................................7
4 2: Side effects of suggested therapies and medications............................................................7
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9

INTRODUCTION
Child and Adolescent psychopathology basically refers to the study of the sort of mental
disorders in the adolescents and the children. These disorders are first diagnosed at the time of
childhood. The disorders can be autism spectrum disorder, oppositional defiant disorder and the
attention-deficit hyperactivity disorder. It becomes necessary to focus on these disorders as they
must be cured on the priority as with the growing age, these disorders increase at rapid rate
instead of improving (Beauchaine and Hinshaw, 2017). The report will analyse a case study of a
boy named Martin by using the differential diagnosis along with providing rationale for
hypothesis. The report will be done by analysing all the aspects of the case study and will help in
providing the diagnosis and interventions for the same. It will also describe some considerations
while giving the pharmacotherapeutic interventions.
1. Differential diagnosis for choice of hypothesis to Martin as per the main reason of his
behaviour
In regard to Martin, 10 year old boys it is found that he is suffering some problems and
experiencing some kind of difficulty in school. It can be considered as a child psychopathology.
This child psychology can help out in knowing reasons of this behaviour. It can help out in
providing or suggesting better diagnosis to him. Before suggesting different and appropriate
diagnosis to Martin for his aggressive behaviour it is important to know the main reason ((Trent,
Dooley and Dougé,2019) . Reasons help out in better treatment and diagnosis. From the study it
is known that Martin has different suicidal thoughts, and he often said to his class teacher that he
wants to die. In this context, his mother, Carmen said that he often said to his mother that he does
not want to live at home and want to die. Several reasons have been found from the study by
talking with his mother.
Reasons of Martin's behaviour
Domestic violence: One of the main reasons that is being found for Martin's aggressive
behaviour is: Domestic violence. It is found that parents of Martin separated some years ago
because of aggressive behaviour of his father and domestic violence, financial difficulties and
abusive behaviours by both mother and father. She lives currently with her boyfriend, but he also
becomes aggressive when he drinks. He becomes very aggressive with Carmen in the presence
of all children, Martin and his 2 sisters Amanda and May, age 15 and 13. So, from this it can
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clearly be said that domestic violence is the main reason of Martin's behaviours. From childhood,
he had seen such behaviours at his home. He meets to his father but his father does not show
much concern even he did not come to meet Martin in hospital when he was admitted for his
appendix removal as it is life threatening surgery (Danese and et.al., 2020).
Insecure child parent attachment: Other main reason that is found and can help out in
suggesting the best diagnosis to him is: insecure child parent attachment. When interviews was
taken with Martin and Carmen together then it is found that Carmen was not much concerned
with Martin. She disengaged herself from her son. There was a lack of connection or attachment
between Martin and his mother. Martin also did not show any sign of affection with his mother.
He was very ungrateful toward his mother. One of the main reason of this lack of attachment is
financial crisis and steady job of her mother. It is found that Carmen had a steady job as sales
assistant as sometimes she had to work in nights and weekend in restaurants.
So, as per the main discussed reasons one of the best diagnosis that can be suggested to
Martin because of his self-destructive behaviour is:
Parental education: On the basis of above discussed reasons it can be said that parental
education is must. By making aware and educated to mother of Martin that how to interact and
talk with Martin, can help out in solving this aggressive behaviour.
Family therapy: Family plays a vital role in managing self-destructive behaviours in children.
So, by focusing on family therapy as a paediatric or by improving decision-making and
communication skills of Carmen, this problem can be solved out in a timely manner
(Behavioural Disorders in Children, 2020).
Cognitive behavioural therapy: It is found that Martin finds problems in controlling his
aggressive behaviours as he told to his teacher. So, it is important to make him able in
controlling his own anger. Cognitive behavioural therapy is all about telling ways to children
about how to control thoughts and behaviour can help Martin and his family from his aggressive
behaviour.
2. Further diagnosis and milestones
Differential diagnosis refers to the diagnosis which has more than one possibility. It is
depended upon the psychologist to choose the main diagnosis among all the possibilities and
then choose the best method for treating the patient. This can be observed that the patient or
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Martin in this case is not faking the symptoms but actually suffering from mental disorder.
Martin is not gaining any benefit from the diagnosis except being cured so he is not faking nay of
the symptoms but the symptoms are due to the things he has faced from his early childhood
which is affecting his later years of the life. There are also some drug related causes because
according to the case study, both the parents of Martin were involved in drug abuse and when he
was born also his parents has a major fight after having drugs. This is clearly examined that these
changes in the behaviour can also be due to the drugs in his body because of the intake of drugs
by his parents. So, this can be evaluated that the symptoms are also due to some drugs as well as
due to the mental health disorders due to the situation, environment and the background of the
Martin’s family. Martin also did not suffer from other medical problems like diabetes, sleep
disorders or any other issue so it can be stated that all the symptoms are due to the mental
disorder and no other disease. The disorders were mainly due to the family problems which are
faced by him from early childhood.
Martin is 10 years old and at this tender age he was showing abnormalities in his behaviour due
to some family problems. He was much aggressive and always talked about his wish to due and
also made many attempts to die but his mother had stopped him to do so. His mother has also
sought help from one of the famous hospital in the city but refused to admit him. Martin had not
only shown such behaviours at home but also in the schools in front of the teachers. He often
became aggressive if something is not done according to him instead against him. The further
diagnosis can be done by observing the separation of his parents when he was too young.
Also, at a very tender age, Martin was aware of the financial problems in his family and due to
which his parents always fought with each other and the fight reached to the happening of
violence (Barker, Walton and Cecil, 2018). The behaviour was also due to the hatred for some
subjects. Though martin could read well but faced various difficulties in writing and
understanding the concepts which were read or taught. The teacher and the students of the
Martin’s school were also fed up by Martin as he was regularly involved in fighting with the
classmates and for which his mother was also called many times but she ended up by comparing
him with his father. Martin also does very weird things in classroom which suggests that he
shows what he has watched his father doing. He did not understand about the feelings and
emotions of others and behave in a way he wants to behave like his father. He was much small
that he did not know the difference between right or wrong. In this behaviour, her mother had
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also contributed by criticising him every time (de Bruin and et.al., 2018). Instead of showing
love and affection to Martin, she always leave the house when couldn’t face the situation. This is
why Martin also did not like her and always wanted that it is better that she is not there at home.
3. Interventions
In order to treat Martin, the most important intervention is to make him feel safe and
calm along with showing love and affection towards him. This needs a sequential, individualized
approach regarding the intervention and then the treatments must be given to him. The
psychologist is not only responsible for improving the conditions of Martin but the main role is
played by the people with whom he lives and comes in contact with regularly. Psychologist
interact with Martin once in a week or once in a month but the people who face Martin daily are
responsible for the deteriorating condition of Martin. The family which included the mother and
two sisters basically must analyse the situation of Martin and must strive hard to provide him
with a calm and peaceful environment without violence (Stevanovic and et.al., 2017). Martin’s
mother must not take drugs as if she did not take drugs can analyse the situation of Martin in
much better way and can understand the reason behind the same. The parents of Martin must sort
out the differences between them as it is affecting the mental and physical life of the child along
with destroying his career. The teachers and the friends of Martin must also make him feel loved
by praising the good things he does. They must not force or dominate Martin for anything
instead makes him feel important. The two sisters of Martin though small can show a sense of
care and concern towards him so that he can stay at home peacefully instead of being involved in
destructive things. The community must also support Martin and make him understand the things
in a peaceful manner so that instead of destructive behaviour, he can share his opinions and
views to someone close to him (Martel, Markon and Smith, 2017). Besides all these, the main
role is played by his mother as mother is someone who can understand the child as no one can so
she must not criticize him in any case and must make him feel like she is always there with him
in all the situations. After doing all these things and improving the environment of the home, the
psychologist must treat him with medicines and injections which can help in making him calm
and must monitor the changes in his behaviour regularly.
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4 1 Considerations need to be taken when considering pharma-therapeutic interventions to
children
Before delivering and providing pharmacotherapy to children main three things need to be
considered such as: potential drug related problems, medical records and family background. All
these factors help out in knowing side effects of suggesting doses and intervention. Accordingly,
situations can be managed (Bradbury‐Jones and Isham, 2020).
In the case of Martin it can be said that knowing past medical history and family
background is must before suggesting or delivering pharmacotherapy intervention. As per the
family background or history of Martin, some effective therapies that can be suggested include:
Cognitive behaviour therapy: In this therapy children or Martin can be made aware about
consequences of his behaviour. This therapy can also help him out in knowing better ways of
controlling himself and his anger. By controlling his anger he can focus on his study as well and
it can also improve his relation with other students and his class teacher in school.
Medications: Risperdal is the main effective medicine that can be suggested to Martin because
he is becoming aggressive day by day. It is becoming very hard to control him. By taking this
medicine daily for around 10 weeks, such suicidal and aggressive behaviour can be decreased in
Martin in initial stage. Lorazepam can also be suggested (Hayes and Hofmann, 2017)
4 2: Side effects of suggested therapies and medications
Some side effects of Lorazepam medicine that are common and may occur in children
and Martin are: dizziness, loss of coordination, drowsiness and blurred vision. Because of all
these side effects, Martin may face problems in his study. It may make him irritate. So, it is
important to suggest lower doze to him.
Some side effects that may occur and Martin face if he is suggested to take Risperdal are:
vomiting, nausea, constipation, increased saliva and increased appetite. All these side effects can
make him irritated. So, it is important for his mother to take extra care of him and communicate
in an effective manner. As per the reasons, it is important to make him feel concerned and
valued. It can have better impact on him (Martin, 2020)..
So, from the above discussed therapies and medicines it can be said that by involving
family members and mother of Martin, aggressive behaviour in him can be reduced to the great
extent.
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CONCLUSION
On the basis of above study it has been concluded that child psychology or study of
conscious childhood development plays a vital role. It helps in solving aggressive and self-
destructive behaviour in children in a timely manner. It has also discussed reasons of knowing
family background and the history of child for knowing the reason of their aggressive behaviour.
It helps in providing better diagnosis. It has also discussed reasons of considering several factors
while suggesting or providing pharmacotherapy interventions for children along with side effects
that may occur. Side effects of medicines related to aggressive behaviour in children also makes
irritated to children so, care by family members play a vital role.
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REFERENCES
Books and Journals
Barker, E.D., Walton, E. and Cecil, C.A., 2018. Annual Research Review: DNA methylation as a
mediator in the association between risk exposure and child and adolescent
psychopathology. Journal of Child Psychology and Psychiatry. 59(4). pp.303-322.
Beauchaine, T.P. and Hinshaw, S.P., 2017. Child and adolescent psychopathology. John Wiley
& Sons.
Bradbury‐Jones, C. and Isham, L., 2020. The pandemic paradox: The consequences of COVID‐
19 on domestic violence.
Danese, A. and et.al., 2020. Child and adolescent mental health amidst emergencies and
disasters. The British Journal of Psychiatry.216(3). pp.159-162.
de Bruin, E.J. and et.al., 2018. Improvements of adolescent psychopathology after insomnia
treatment: results from a randomized controlled trial over 1 year. Journal of Child
Psychology and Psychiatry. 59(5). pp.509-522.
Hayes, S.C. and Hofmann, S.G., 2017. The third wave of cognitive behavioral therapy and the
rise of process‐based care. World Psychiatry. 16(3). p.245.
Martel, M.M., Markon, K. and Smith, G.T., 2017. Research Review: Multi‐informant integration
in child and adolescent psychopathology diagnosis. Journal of Child Psychology and
Psychiatry. 58(2). pp.116-128.
Martin, K.B., 2020. Accuracy of Psychiatrists’ Assessment of Medication Adherence in an
Outpatient Setting. Cureus. 12(12).
Stevanovic, D. and et.al., 2017. Can we really use available scales for child and adolescent
psychopathology across cultures? A systematic review of cross-cultural measurement
invariance data. Transcultural Psychiatry. 54(1). pp.125-152.
Trent, M., Dooley, D.G. and Dougé, J., 2019. The impact of racism on child and adolescent
health. Pediatrics. 44(2).
ONLINE
Behavioural Disorders in Children. 2020. Online Available through:
<https://www.betterhealth.vic.gov.au/health/healthyliving/behavioural-disorders-in-
children>.
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