CONCEPT MAP
Bella is 9 years old and in the 4th grade. Bella’s mother sought treatment due to increasing disruptive behaviors over the past year, including non-compliance, physical aggression toward peers, and frequent behavioral meltdowns which resembled the temper tantrums of a much younger child. Tantrums included screaming, yelling, slamming doors, and crying. Bella and her mother both noted that it was difficult for Bella to “move on” when something angered her. She also noted that Bella had an underlying irritable mood, manifesting as Bella appearing “cranky” most of the time and the family feeling they needed to “walk on eggshells” to avoid upset. At school, at least one phone call home per week was being placed due to Bella’s refusal to comply or sometimes to even speak to her teacher for days at a time. Bella and her mother noted that Bella was generally well-liked by peers and teachers, given that she was hardworking and funny, yet her current disruptive behaviors were causing significant interference in making new friends and meeting academic goals.
Concept Map Information
What is the Main diagnosis for BELLA?
What are the Key symptoms?
What differential diagnoses did you consider and why?
What is your treatment recommendation and why?
What is the Prognosis?
Sample Solution
Concept Map Information
Main diagnosis for Bella: Oppositional defiant disorder (ODD)
Key symptoms:
- Non-compliance with requests or rules from authority figures
- Defiant or argumentative behavior
- Deliberately annoying others
- Blaming others for mistakes or misbehavior
- Spiteful or vindictive behavior
- Touchiness or irritability
- Anger and resentment
- Frequent temper tantrums
Full Answer Section
Differential diagnoses:
- Conduct disorder (CD): CD is more severe than ODD and is characterized by persistent and pervasive patterns of aggression, destruction, and deceit. Bella's behaviors, while disruptive, do not appear to meet the full criteria for CD.
- Attention-deficit/hyperactivity disorder (ADHD): ADHD is characterized by inattention, hyperactivity, and impulsivity. Bella does not appear to exhibit significant inattention or hyperactivity.
- Anxiety disorder: Anxiety disorders can cause irritability, anger, and tantrums in children. However, Bella's disruptive behaviors are not accompanied by other symptoms of anxiety, such as excessive worry, fear, or avoidance of feared situations.
- Mood disorder: Mood disorders, such as depression or bipolar disorder, can also cause irritability and anger in children. However, Bella's disruptive behaviors are not accompanied by other symptoms of a mood disorder, such as sadness, loss of interest in activities, or changes in sleep or appetite.
Treatment recommendation:
The recommended treatment for ODD is a combination of individual therapy and parent training. Individual therapy can help Bella to learn how to manage her anger and emotions, and to develop more appropriate coping mechanisms. Parent training can help Bella's parents to learn how to set clear and consistent expectations, and to respond effectively to Bella's disruptive behaviors.
Prognosis:
The prognosis for children with ODD is generally good. With appropriate treatment, most children are able to learn to manage their symptoms and to function successfully in school and at home.
Concept Map:
Central Topic: Oppositional defiant disorder (ODD)
Related Topics:
- Symptoms of ODD:
- Non-compliance with requests or rules from authority figures
- Defiant or argumentative behavior
- Deliberately annoying others
- Blaming others for mistakes or misbehavior
- Spiteful or vindictive behavior
- Touchiness or irritability
- Anger and resentment
- Frequent temper tantrums
- Differential diagnoses:
- Conduct disorder (CD)
- Attention-deficit/hyperactivity disorder (ADHD)
- Anxiety disorder
- Mood disorder
- Treatment recommendations:
- Individual therapy
- Parent training
- Prognosis:
- Generally good with appropriate treatment
Arrows between topics indicate relationships:
- ODD is characterized by a cluster of symptoms, including non-compliance, defiance, and aggression.
- ODD may be confused with other disorders, such as CD, ADHD, anxiety disorders, and mood disorders.
- The recommended treatment for ODD is a combination of individual therapy and parent training.
- With appropriate treatment, the prognosis for children with ODD is generally good.