Reginald Calley, a 10-year old boy, was presented for psychological examination and assessment in a bid to determine evidence of depression. His mother, Maurine, was concerned that Reginald displayed inappropriate behavior which includes yelling, hopelessness, anorexia, being consistently sad, poor school performance, increased irritability, and temper tantrums, argue excessively, ignore teachers' instructions and always failed to complete school assignments. These symptoms have persisted for more than one year. Maurine indicates her son, Reginald, is experiencing emotional disturbances most of the time and this is the core reason that necessitates referral.
Sources of information
Background information was obtained from his mother who had accompanied him, school performance and behavior reports. This information was obtained from an interview, rating scales and development history.
a) Family history
Maurine and Nicolas, who is Reginald father, are happily married. The couple has a good relationship with their two kids. Reginald being a young one and his sister is four years older. Nicolas is a rather busy man and is away from home most of the time due to work commitments, but Maurine insists that they still in a happy and exciting relationship, even in the situations when they are apart. Nicolas and his family are living in an urban setup. In spite of the fact that Nicolas is working, his income is insufficient to meet the family economic needs. Furthermore, Maurine is still unemployed.
B) Medical History and Development History
Maurine describes Reginald as having good health with no history of any critical illness, surgeries, and accidents during his childhood. Reginald's mother reported that she was 32 years old when she gave birth to her son, while Reginald's father was 35 years old. There was no complication during pregnancy, and he was delivered via cesarean section. His birth weight was within the normal limits. However, Reginald experienced difficulties in milestone development. During infancy, he had insomnia and displayed anorexia. He is also reported to have experienced a delayed bowel and bladder control.
Reginald was a child 16 sports star prodigy in the cricket sport by the age of eight, and he won several medals, which are still very new and hanged in his bedroom wall cabinets. When he was in the sport, he would be very surrounded by people who were trying to better him at the sport, and as such, a lot might have happened by that period. Unfortunately, seeing as his father is always away on business, it was difficult for him to have a male figure as a role model. As such, the more he continued playing, it became evident that he was away from home most of the time on training. The moments when he was home, he was in school or catching up with a home trainer on his education. His mother on the other hand upon further inquisition was very concerned with organizing parties for his son and having friends over that the only time left for bonding with her child was limited.
Upon further research, we found out that the boy had had exposure to some hard drugs and which we anticipate that was the cause of his problems, which he is experiencing now. Upon testing, it was found that his blood had some indications of heroin and cocaine and seeing as this drugs have awful withdrawal symptoms, they may have caused this current situation. We made the decision to look for the people who were around him and who were training him, and one of them was a drug addict at the moment, and this pointed us to have verified our assumptions. We applied some measures, and we finally got them to admit that they gave Reginald doses of the drug so that he could have an adrenaline enough to have him charged enough to play with energy and win.
She narrates that Reginald is not very upbeat and does not display that eagerness; he looks to be overwhelmed by emotional tension, lack overall positive attitude and fails to express his feelings precisely. Reginald is disinterested in most of the activities that his age mates do like to engage. Furthermore, he displays low self-esteem, constant feeling of sadness, poor concentration, poor appetite and difficulties in making decisions.
Wechsler Intelligence Scale for Children Fourth Edition (WISC - IV) (takes 80 minutes
Attention Deficit Hyperactive Disorder Behavior Rating Scale Test (Takes 20 minutes)
Behavior Assessment System for Children, Second Edition (BASC-2)
Child Depression Inventory (takes 15 minutes)
Minnesota multiphasic personality test
Personality assessment inventory
Thematic Appreciation Test
The test results are reported at 95% confidence interval. The expression is below the average range and ranked in the 39th percentile. This shows that his performance exceeded that of 39 percent of children his age in the population. It is likely that his verbal abilities are between low averages of 89 to an average of 103. Reginalds performance varied among verbal tasks. His highest score was on a task demanding him to demonstrate knowledge about the similarity of two items or concepts. He also did well in areas that deal with general knowledge and information. He scored poorly in areas that require the general application of concepts. Reginalds perceptual reasoning was found to below average range and ranked in the 21st percentile. It is likely that his rational perceptual abilities fall into a range from a low average of 81 to average of 97.
Reginald's results, when subjected to Attention Deficit Hyperactive Disorder Behavior Rating Scale, indicate the presence of ADHD symptoms. Conners' Teacher Rating Scales, Child Behavior Checklist/Teacher Report Form, and DSM-IV SNAP checklist, all gave positive results on symptoms that are linked to ADHD. Symptoms which include lack of concentration, interpersonal problems, hopelessness, ineffectiveness, lack of calm and irritation, were predominant symptoms identified on the ADHD rating scales.
Reginalds academic performance was measured using Basic Skill Achievement inventory survey (BASI-Survey).His overall performance is below average and rank in the seven percentile (BASI-2 Survey RT= 78; 7th percentile).
The children Depression Inventory results showed evidence of anhedonia (decreased inability to experience joy or happiness), negative self-esteem, ineffectiveness or lack of motivation, interpersonal problems or and failure to keep friends and irritability.
When subjected to the MMPI 2 test of personality Reginald indicated that he scored T=55-64 dissatisfied with life situation; introverted, withdrawn; restricted range of interests; lacking in self-confidence. This was a result from the second scale of depression, and this clearly showed some signs of a person who may have been a drug addict. On the psychopathic deviate (Pd) he indicated that he had some problems too and he scored a score of T = 65-74. This is usually very high, and it showed that he was Rebellious, non-conforming, had numerous family problems, he was impulsive, angry, irritable, dissatisfied, had poor work history because his grades were low unlike before where he would come out the top of his class.
Reginald also took the personality inventory test, and it showed that on the parameter for drug abuse his response was an ST, which indicates that this was slightly true and he may have been inclined to admit this because he was in dire need to be helped. He was upsetting his parents when he got into these anxieties, but when he was fine, he showed regret over wanting to have a good relationship with his parents. On the parameter of delusions, he showed an F which is false, and it could be because the drugs had not one any bad damage to his system, which showed that he, could at least be rehabilitated and finally get back to normal.
The thematic appreciation test showed that he had high scores on the Defense Mechanisms Manual DMM, which was an indication that he had denial issues, the projection of his problems and issues of identification. Identification issues are not usually common with a ten-year-old, and as such, it was worrying to find that he had issues with his identity the reason why he was into wearing some very extreme fashion which did not match his age. On the Social Cognition and Object Relations SCOR, he scored low because his relationship with his parents was worrying and it was all as a result of the problems which were brought about by the drugs which had been administered to him as a child when he was a sports prodigy playing cricket.
Diagnosis and Summary
There are various structured interviews, questionnaires and rating scales that are used in research and may help in the diagnosis, management, and follow-up of children with depression symptoms. Based on the interview and test results, it can be observed that Reginald has emotional disturbance and mood disorders that have adversely interfered with his school life, social interaction, and coping. It is usually difficult to diagnosed particular mood and depression disorders owing to overlapping and shared symptoms. The depressions or mood disorders symptoms in adults and children are almost similar (Reynolds & Johnston, 2013). There is a possibility that Reginald has Attention Deficit Hyperactive Disorder (ADHD) due to poor performance at school and dysthymic disorder. Poor appetite, lack of concentration and hopelessness are some few symptoms available in dysthymic disorder (American Psychiatric Association, 2013). There are no particular tests that can assist in the diagnosis of ADHD, but there are some procedures that can facilitate the diagnosis which include a medical examination to rule out other probable causes of symptoms and information gathering that is linked to current health status, family history, and school records. Other diagnosis interventions include questionnaires and interviews, ADHD rating scales and ADHD diagnosis criteria from the Diagnostic and Statistical Manual of Mental Disorders. Reginalds mood disorders and symptoms are sufficient to support the diagnosis of the two named disorders. Major depression disorder may be ruled out due to the absence of severe symptoms that are associated with major depression.
Children, especially school going ones like Reginald are likely to internalize environmental problems like family conflicts, failure to achieve academically and criticism; this can lead to low self-esteem and excessive quilt. The inner turmoil can be expressed through a somatic presentation which includes irritability, anxiety, and fear. The stressors are likely to aggravate existing mood disorders and symptoms. Thus, it becomes critical for parents and teachers to provide a suitable environment does not harbor stressors.
For Reginald to have such results is a clear indication that his ADHD is partly as a result of the drugs which were given to him by his trainers and it, in fact, was likely to have very dire consequences because drugs on such a child are likely to harm his brain and his functionality. The reason for him not playing was because the problems with his personality and the anxieties disorder rendered him to be in a position where he could no longer play, and this was very disappointing because he had a very promising career ahead of him. Clearly, drugs ruined his life even though he did not take them willingly.
The focus should be directed towards the management of depression. Several treatment approaches have been developed for the management of depression. These approaches can be implemented individually or in groups. Peer grou...
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