Child and Adolescent Psychopathology Fourth Edition 2 3 Child and Adolescent Psychopathology A Casebook Fourth Edition Linda A. Wilmshurst 4 FOR INFORMATION: SAGE Publications, Inc. 2455 Teller Road Thousand Oaks, California 91320 E-mail: [email protected] SAGE Publications Ltd. 1 Oliver’s Yard 55 City Road London EC1Y 1SP United Kingdom SAGE Publications India Pvt. Ltd. B 1/I 1 Mohan Cooperative Industrial Area Mathura Road, New Delhi 110 044 India SAGE Publications Asia-Pacific Pte. Ltd. 3 Church Street #10-04 Samsung Hub Singapore 049483 Copyright © 2018 by SAGE Publications, Inc. All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher. Printed in the United States of America Library of Congress Cataloging-in-Publication Data Names: Wilmshurst, Linda, author. Title: Child and adolescent psychopathology : a casebook / Linda A. Wilmshurst, Elon University. Description: Fourth edition. | Thousand Oaks : SAGE, [2018] | Includes bibliographical references and index. Identifiers: LCCN 2017027063 | ISBN 9781506349350 (pbk. : alk. paper) Subjects: LCSH: Child psychopathology—Case studies. | Adolescent psychopathology—Case studies. Classification: LCC RJ499 .W46 2018 | DDC 616.8900835—dc23 LC record available at https://lccn.loc.gov/2017027063 This book is printed on acid-free paper. Acquisitions Editor: Abbie Rickard Editorial Assistant: Jennifer Cline Production Editors: Libby Larson and Veronica Stapleton Hooper Copy Editor: Diane DiMura Typesetter: C&M Digitals (P) Ltd. Proofreader: Lawrence W. Baker Indexer: Karen Wiley 5 Cover Image: Rachel Wilmshurst (www.rachelwilmshurst.com) Cover Designer: Candice Harman Marketing Manager: Jenna Retana 6 Contents Preface Acknowledgments About the Author 1 Introduction: Understanding the Complexities of Child and Adolescent Psychopathology 1 Terry Hogan: The Avoidance Trap (10 years old) Developing a Case Formulation 2 Jeremy Jones: Mommy and Me and Grandma Makes Three (6 years old) Developing an Intervention Plan 3 Neesha Wilson: Phoenix Rising (10 years old) Risks, Protective Factors, and Psychological Well-Being 2 Introduction to Neurodevelopmental Disorders Part A: Problems of Attention and Specific Learning Disorders 4 Colby Tyler: Attention Problems or Distracted by Life? (14 years old) ADHD; Gifted; Divorce 5 Thomas McLearn: Read Me a Story (10 years old) Dyslexia 6 Sandy Smith: Marching to the Tune of a Different Drummer (8 years old) Nonverbal Learning Disability Part B: Autism Spectrum Disorders (ASD) and Intellectual Disabilities (6 years old) Mild Variant of ASD 7 Dylan Bach: The World According to Dylan (6 years old) Mild Variant of ASD 8 Arthur Watson: Won’t or Can’t: a Case of Mistaken Identity (15 years old) Intellectual Disability; Parent Denial; Academic and Behavior Problems 9 Brian Williams: My Name Is Williams, Too (10 years old) Williams Syndrome 10 Bradley Hunter: Not Yet Diagnosed (5 years old) Neurodevelopmental Symptoms 3 Introduction to Disruptive Behavior Disorders 11 Scott Michaels: Boys Will Be Boys? (9 years old) Oppositional Defiant Disorder; ADHD 12 Tyrone Wilson: The Gang’s All Here (15 years old) Neesha’s Brother; Multifinality; Learning and Behavior Problems; Gang Activity, Forensic Assessments; Fetal Alcohol Spectrum Disorders 4 Introduction to Anxiety and Compulsive Disorders 13 Winnie Kent: Silence Is Not Golden (5 years old) Separation Anxiety Disorder; Selective Mutism 14 Shirley Yong: Worried to Perfection (11 years old) General Anxiety Disorder; Depression; Relational Aggression; Cultural Conflict; Trichotillomania 15 Jordan Neeson: Let Me Count the Ways (9 years old) Obsessive-Compulsive Disorder 16 Sandra Silver: Shy or Social Anxiety Disorder (Social Phobia) (15 years old) Social Anxiety Disorder 5 Introduction to Problems of Mood: Depression and Bipolar Disorders 17 David Steele: Hopelessness and Despair (17 years old) Adolescent Depression; Suicidal Ideation 7 18 Matthew Morgan: Out of Control and In Control (9 years old) Child-Onset Bipolar Disorder/Mood Dysregulation Disorder 19 Jenny Sloan: The All-American Girl (16 years old) Bipolar Disorder; Suicide Attempt 6 Introduction to Disorders of Emotion and Behavior Dysregulation 20 Alex Bishop: The Slippery Slope (15 years old) Substance Use; Multidimensional Family Therapy (MDFT) 21 Sarah Burke: Food for Thought (16 years old) Disordered Eating and Eating Disorders 22 Tori Benson: Skin Deep: Cutting Through the Pain (16 years old) Self-Mutilation; Borderline Personality Disorder 7 Introduction to Traumatic and Stress-Related Disorders 23 Juan Hernendez: The Crash (16 years old) Posttraumatic Stress Disorder; Survivor Guilt 24 Jason Coleman: Disconnected Connections (16 years old) Conduct Disorder; Reactive Attachment Disorder; Traumatic Childhood 25 Ericka White: Not Yet Diagnosed (10 years old) APPENDIX A: Supplemental Case Information APPENDIX B: Systems of Classification APPENDIX C: Guidelines to the Interpretation of Test Scores and Assessment Information Index 8 9 Preface Tell me and I’ll forget. Show me, and I may not remember. Involve me, and I’ll understand. —Native American Proverb The major goal of this casebook is to provide the reader with an opportunity to gain deeper insight into the complexities of child and adolescent psychopathology and to apply this knowledge within the context of the diagnostic framework of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013). A case study approach is used to involve the reader in the simulated practice of child psychopathology. As problems unfold, a dynamic illustration of a given child’s problems can be observed during several different stages of development and from the perspective of different theoretical viewpoints. Within a developmental context, complex problems of child and adolescent adjustment become grounded in the realities of family and school experiences. Case studies presented in this text are especially relevant to the study of child and adolescent psychopathology, because all cases are based on actual clinical cases. Although the cases have been altered to maintain confidentiality, they continue to represent actual living files, and as such, provide a unique opportunity to capture the dynamics of child and adolescent psychopathology in virtual presentations of life as the children develop and their stories unfold before the reader’s eyes. Cases have been selected to include a breadth of childhood and adolescent psychopathology and are representative of the high rates of comorbidity demonstrated in this population. Each case presents an opportunity to practice and develop clinical skills in the assessment, diagnosis, and treatment of childhood disorders from a number of theoretical perspectives and at various levels of interest and expertise. The text is suitable for upper level undergraduate students in its rich presentation of case materials that demonstrate applications of many of the core concepts in child psychopathology (e.g., how therapists from differing theoretical backgrounds would approach a given case). The text is suitable for graduate students in providing opportunities to practice and hone clinical skills across a breadth of clinical cases with opportunities for in- depth discussion and application in specialty areas of concentration: assessment, diagnosis, and treatment. The text can be a valuable resource for courses in child psychopathology, abnormal child psychology, developmental psychopathology, school psychology, behavior problems of childhood, child psychotherapy, child assessment, and case formulation in child psychopathology. Case studies provide diagnostic information at two levels. Case studies are presented to illustrate the dual nature of diagnosis in its emphasis on diagnosis as case formulation (an ongoing process of information gathering, problem solving, and hypothesis testing) and diagnosis as the formulation of an outcomes statement (the classification or conclusion). Case studies provide comprehensive assessment information. Case information is available from a variety of sources (case history, observations, psychometric assessment, raw data, and clinical interviews) and developmental contexts (individual child, family, school, and peers) to encourage students to 10