CASE ANALYSIS EVALUATION:DISRUPTIVE DISORDERS 3
Case Analysis Evaluation:Disruptive Disorders
Chief Complaint: “They make me mad.”
Symptoms:
A. History/History of Present Illness: Identify the history questions you will obtain to
discriminate the characteristics of the presenting chief complaint (symptom)
I. Characteristics:
II.
III. Onset:
IV.
V. Lingering:
Duration:
Stressors:
Precipitating factors/triggers:
Alleviating factors:
B. Differential Diagnosis: Delineate four differential diagnoses that could support the chief
complaint and HPI. Include DSM-5 diagnostic code for each of the differential diagnosis.
C. Mental Status Examination: Delineate mental status exam findings associated with each
listed differential diagnosis
Differential
1: Disruptive
Mood
Dysregulatio
n Disorder
Differential
2: Conduct
Disorder
Differential
3:
Oppositional
Defiant
Disorder
Differential
4:
Intermittent
Explosive
Disorder
CASE ANALYSIS EVALUATION:DISRUPTIVE DISORDERS 4
I.
Differ
ential 1:
Disruptive
Mood
Dysregulatio
n Disorder
Appearance-
Speech-
Affect-
Mood-
Behavior-
Thought process-
Thought content-
Attention and concentration-
Memory-
Orientation-
Insight-
Judgment-
Intelligence-
II.
Differential
2: Conduct
Disorder
Appearance-
Speech-
Affect-
Mood-
Behavior-
Thought process-
Thought content-
Attention and concentration-
Memory-
Orientation-
Insight-
Judgment-
Intelligence-
Differential
3:
Oppositional
Defiant
Disorder
Appearance-
Speech-
Affect-
Mood-
Behavior-
Thought process-
Thought content-
Attention and concentration-
Memory-
Orientation-
Insight-
Judgment-
Intelligence-
(Terlizzi & Villarroel, 2020).
Differential
4:
Intermittent
Explosive
Disorder
Appearance-
Speech-
Affect-
Mood-
Behavior-
Thought process-
Thought content-
Attention and concentration-
Memory-
Orientation-
Insight-
Judgment-
Intelligence-
(American Psychiatric Association, 2022).
CASE ANALYSIS EVALUATION:DISRUPTIVE DISORDERS 5
D. Etiology: Delineate the etiology of each of the four differential diagnoses. Include
psychosocial factors and past experiences that may be contributing to current symptoms
E. Diagnostic Screening Tools: Delineate what diagnostic screening tools would be
appropriate for each of the four differential diagnose
F. Analysis: Delineate your final assessment along with the rationale:
G. Treatment Plan: Delineate appropriate treatment plan which should include
pharmacological, psychological therapeutic modalities and the focus, social interventions
(support or self-help groups, mobilization of family resources, vocational rehabilitation,
financial planning) and identification of strengths.
Pharmacological Treatment
Non-pharmacological treatment
Differential
1: Disruptive
Mood
Dysregulatio
n Disorder
Disruptive mood dysregulation disorder (DMDD) presents as severe irritability in children
and adolescents=(American Psychiatric Association, 2022). Individuals with DMDD will
exhibit verbal or behavioral outbursts several times weekly and experience chronic anger
and mood instability.= Children with DMDD will have chronic anger and irritability for a
period of 12 months or more.=Additionally, these children will demonstrate symptoms in at
least two settings. Children younger than six or older than 18 are not diagnosed with DMDD
(Boland et al., 2022). Dan’s symptoms of anger and aggression towards staff and his peers,
along with his psychiatric history of aggression in preschool, may lead the clinician to steer
towards a diagnosis of DMDD.
Differential
2: Conduct
Disorder
Conduct disorder (CD) presents as physical aggression towards others and animals=(Kilgus
et al., 2015, Chapter 23).= The presentation of conduct disorder in children and adolescents
goes far beyond irritability and temper tantrums. Although these individuals try to maintain
or project the “tough guy” or “tough girl” image, they generally have low self-
esteem=(Kilgus et al., 2015, Chapter 23).= The DSM-5 criteria for a diagnosis of conduct
disorder is the persistent pattern of dissocial, aggressive, or defiant conduct for a minimum
of six months.= Dan’s history affirms that his violence towards others includes attacking a
peer,=which led to an assault charge and mandated anger management class.= His most recent
act of violence occurred at the group home, where he assaulted a staff member and broke
furniture.= His psychiatric history is positive for defiance, bossiness, and aggression. Hence,
Dan meets the DSM-5 criteria for conduct disorder.=
Differential
3:
Oppositional
Defiant
Disorder
Differential
4:
Intermittent
Explosive
Disorder
Intermittent explosive disorder (IED) is characterized by sudden infrequent outbursts,
tantrums and destructive behavior that may last for minutes to several hours=(Kilgus et al.,
2015, para. 23). Individuals with intermittent explosive disorder may have an underlying
developmental disorder such as speech delay or learning disabilities=(Kilgus et al., 2015,
para. 23). Dan's psychiatric history provides information about his violent outbursts as well
as falling behind in his academics.
Differential
1: Disruptive
Mood
Dysregulatio
n Disorder
Differential
2: Conduct
Disorder
Differential
3:
Oppositional
Defiant
Disorder
Differential
4:
Intermittent
Explosive
Disorder
