Posted: September 8th, 2023

Concept Map 1 Mary Rose is nine years old

Concept Map 1 Mary Rose is nine years old. She is adopted. Her biological mother suffered from depression and her biological father was abusive. Mary Rose was removed from the home at age three, but not before witnessing excessive arguing between her parents, including physical fighting. Mary Rose spent time in foster care before being adopted three years ago. She has had difficulty adjusting to her new family and school. She initiates fights with her classmates and seems to enjoy intimidating them. She takes others’ possessions and destroys them just for fun. Last week she rode her bicycle outside of her neighborhood and was gone for three hours. She lied to her parents about where she had been and couldn’t understand why they were worried about her.Concept Map Information

What is the Main diagnosis for Mary Rose?
What are the Key symptoms?
What differential diagnoses did you consider and why?
What is your treatment recommendation and why?
What is the Prognosis?
(Concept maps are visual representations of information. They can be charts, graphic organizers, tables, flowcharts, Venn Diagrams, timelines, or T-charts. )

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DUE DATE SEPTEMBER 7, 2023

Understanding Childhood Trauma and Its Long-Term Effects: The Case of Mary Rose
Childhood trauma can have profound and long-lasting impacts on a child’s development, behavior, and mental health. The case of nine-year-old Mary Rose demonstrates how early adverse experiences like abuse, neglect, and family dysfunction can shape a child’s life in both the short and long term. By examining Mary Rose’s background and current symptoms, we can gain insight into how to best support children who have endured trauma.
Mary Rose was removed from her biological parents’ home at age three due to her mother’s depression and her father’s physical abuse (Concept Map, 2023). She spent time in foster care before being adopted three years ago. Witnessing excessive arguing and domestic violence as a toddler severely disrupted Mary Rose’s early attachment experiences and sense of safety (Tronick, 2007). This type of trauma has been linked to later difficulties with emotional regulation, impulse control, and interpersonal relationships (Anda et al., 2006).
Since her adoption, Mary Rose has exhibited concerning behaviors like initiating fights at school, taking and destroying others’ belongings, and wandering away from home (Concept Map, 2023). She seems to derive pleasure from intimidating peers and does not understand her parents’ worry when she puts herself in dangerous situations. These actions could represent attempts to regain a sense of control after past powerlessness, as well as difficulties with empathy that are common in children who have experienced family violence (van der Kolk, 2017).
Based on her history and presentation, the most likely primary diagnosis for Mary Rose is Disruptive Behavior Disorder (DBD), specifically Intermittent Explosive Disorder (American Psychiatric Association, 2013). Key symptoms include impulsive aggression, property destruction, deceitfulness, and lack of regard for safety. Differential diagnoses considered but less likely include Oppositional Defiant Disorder (ODD), which does not fully account for her pleasure in intimidating others, and Conduct Disorder (CD), which typically emerges later in development.
The treatment approach for Mary Rose should focus on building safety, stability, and healthy attachments through trauma-informed care (Substance Abuse and Mental Health Services Administration, 2014). Therapy addressing her traumatic past using modalities like Parent-Child Interaction Therapy and Cognitive Behavioral Therapy could help improve emotion regulation and social skills. Safety planning and close supervision are also needed to manage risk-taking behaviors.
With a supportive family environment and trauma-focused interventions, Mary Rose’s long-term prognosis is cautiously optimistic (van der Kolk, 2017). However, children who experienced early trauma are at elevated risk for ongoing mental health issues like depression, substance abuse, and further behavioral problems if left unaddressed (Anda et al., 2006). Ongoing treatment and family support will be important for Mary Rose to overcome her traumatic history and develop into a well-adjusted adolescent and adult.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. European archives of psychiatry and clinical neuroscience, 256(3), 174–186. https://doi.org/10.1007/s00406-005-0624-4
Concept Map. (2023). Concept Map 1. [Fictional case details].
Substance Abuse and Mental Health Services Administration (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Tronick, E. (2007). The neurobehavioral and social-emotional development of infants and children. New York: W.W. Norton & Company.
van der Kolk, B. A. (2017). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric annals, 35(5), 401-408.

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