Case Studies in Abnormal Child and Adolescent Psychology. Robert Weis
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1 The Science and Practice of Abnormal Child Psychology
Case Study: What Is Abnormal?
Mental health professionals have long struggled with the best way to differentiate mental disorders from mental health. The DSM-5 conceptualization of mental disorders borrows heavily from Jerome Wakefield’s (1992) notion of “harmful dysfunction.” According to Wakefield, disorders reflect an underlying biological or psychological dysfunction that causes harm to the individual. The DSM-5 definition of a mental disorder is reproduced below:
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A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above. (American Psychiatric Association, 2013, p. 20)
Read each of the following brief case studies. Using the DSM-5 definition above, determine if the child in each case study has a mental disorder. If there’s not enough information in the case study, identify any other information you would need to determine if the child meets the DSM-5 definition.
1 Margaret wets the bed at night. She does not wake up until the next morning. Her parents spend a great deal of time and energy washing her pajamas and bedding.
2 Shawn is afraid to ride elevators. Every time he is in an elevator, he experiences intense feelings of panic. He tries to avoid elevators whenever he can.
3 Charlotte is a teenage girl whose father died of a heart attack. Charlotte isn’t eating or sleeping well. She can’t concentrate on her homework or activities at school. Sometimes, at night, she talks with her father about her day before she falls asleep. She also thinks a lot about death.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Wakefield, J. (1992). Disorder as harmful dysfunction. Psychological Review, 99, 232–247.
This case study accompanies the textbook: Weis, R. (2021). Introduction to abnormal child and adolescent psychology (4th ed.). Thousand Oaks, CA: Sage. Answers appear in the online instructor resources. Visit https://sagepub.com.
Case Study: Ethical Dilemmas With Children and Families
Researchers surveyed psychologists about ethical dilemmas that they encountered in their practice. Some of the most common problems involved (1) questions about maintaining confidentiality, (2) potential conflicts of interest, (3) when and how to provide informed consent, and (4) practicing within one’s boundaries of competence (Pope & Vasquez, 2016).
Ethical issues are especially difficult in psychotherapy with children and families. The American Psychological Association’s (2017) ethics code can help psychologists resolve ethical dilemmas. Read each of the following ethics scenarios. Identify the ethical principle that is most relevant to the scenario. Then use this ethical principle to determine how you might act in that situation.
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Ethics Scenario 1: You are a therapist in private practice who has been providing counseling to Aimee, a 15-year-old girl with anxiety and depression. Over the last few weeks, Aimee’s symptoms have worsened and she has admitted to cutting herself. Her mother wants to know what is wrong. What should you do to act in an ethical manner?
Ethics Scenario 2: You are an undergraduate psychology major who is participating in an internship at a residential treatment facility for adolescents with conduct problems. One of the social workers at the facility asks you to lead a group therapy session with several residents each week. The focus of the therapy session will be to help the adolescents develop emotion regulation and social skills. What should you do?
Ethics Scenario 3: You are a behavior therapist working at a special needs preschool. You’ve been assigned to work with Meredith, a 6-year-old girl who has low intellectual functioning and autism spectrum disorder. Meredith becomes angry and tantrums when she must brush her teeth or her hair in the morning. Your task is to reduce the frequency and severity of these tantrums. What must you do to proceed in an ethical manner?
Ethics Scenario 4: You are a psychologist working at a local high school. One of your friends, a teacher at the high school, asks you to help her daughter, a 14-year-old middle school student who has been acting very depressed and withdrawn in recent weeks. After meeting with the girl for a few sessions, you learn that she is sexually active and may be pregnant. What must you do to act in an ethical manner?
References
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. Washington, DC: Author.
Pope, K. S., & Vasquez, M. J. (2016). Ethics in psychotherapy and counseling: A practical guide. New York, NY: Wiley.
This case study accompanies the textbook: Weis, R. (2021). Introduction to abnormal child and adolescent psychology (4th ed.). Thousand Oaks, CA: Sage. Answers appear in the online instructor resources. Visit https://sagepub.com.
2 The Causes of Childhood Disorders
Case Study: Developmental Psychopathology: Continuity and Change
Developmental psychopathology is a multidisciplinary approach to understanding normal and abnormal development over the lifespan. It conceptualizes development in terms of risk and protective factors that place individuals on developmental pathways toward adaptation or maladaptation (Cicchetti & Rogosch, 2002).
Developmental psychopathologists are interested in continuity versus change across development. Almost a century ago, Sigmund Freud wrote about the difficulty in predicting children’s development over time:
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So long as we trace development from its final outcome backwards, the chain of events appears continuous. … But if we proceed the reverse way, if we start from the premises and try to follow these up to the final result, we notice at once that there might have been another result and we might have been just as well able to understand and explain the latter. Hence the chain of causation can always be recognized with certainty if we follow the line of analysis backwards, whereas to predict it is impossible. (Sroufe & Rutter, 1984)
Read the following scenarios and answer each question. What principle of developmental psychopathology does each scenario illustrate?
1 Carlos is a 14-year-old boy with a long-standing history of attention-deficit/hyperactivity disorder (ADHD). He began to show problems with hyperactivity and impulsivity as a preschooler. In early elementary school, he also began exhibiting poor attention and concentration. Now in the eighth grade, Carlos continues to show all of these symptoms. He manages these symptoms with medication