Diagnosis and Assessment of Neurodevelopmental and Disruptive, Impulse-Control, and Conduct Disorders
Among the most prominent list of criteria that overlaps with Marley’s symptoms, the Mild Oppositional Defiant Disorder (ODD) seen in this case is the one that fits with the DSM-5. Marley remains prominent consistently while displaying behavioral expressions such as rebellion, rejection of rules, disputing of authority figures, and the possibility of managing his emotions, which have existed for more than 18 months (Aggarwal et al., 2020). A striking symptom manifestation in his ability to function both at home and in his educational process is a clear diagnostic feature of the ODD entity. The changing pace Marley goes through, of hostility being replaced by fear, is another thing that leads to the diagnosis. Despite his age-appropriate speech and orientation, Marley’s behavior points out a chronic and impairing manner in line with neurobehavioral disorder, which is similar to ODD (Aggarwal et al., 2020).
In the differential diagnoses, the Adjustment Disorder is the most probable because it involves stressors during the birth of Marley’s youngest brother. Nonetheless, such prolonged and severe reactions after the adjustment time exponentially decrease the chances of Adjustment Disorder (Aggarwal et al., 2020). The symptoms that Marley has been experiencing for the past 18 months are longer lasting and seem to be influencing her daily functioning, as evidenced by her irritability and neglect of her schoolwork being similar to ODD symptoms.
The cultural elements play an important part in understanding Marley’s appearance. As a biracial person, Marley could draw from cultural aspects of both races to form his identity, which could lead to him fitting the societal expectations of his community and family. Cultural aspects like gender roles and family position might make him influence how he behaves and his interaction with each family member (Heim et al., 2021). This cultural context strongly influences the type of intervention plan that suits this phenomenon, and studying these interventions will enable the researcher to understand Marley and his familial cultural and religious settings.
ICD diagnosis selected, Z 62.820 (Parent-Child Relational Problem), includes the deterioration of their relations expressed by Marley with his mother, and it also highlights the influential role of psycho-social problems and environmental situations in Marley’s difficulties within the family unit (Jacobs, 2021). Z code provides a framework whereby issues related to the relationship between parents and children will be addressed through evidence or research-based interventions.
References
Aggarwal, A., Lindegaard, V., & Marwaha, R. (2020). Oppositional Defiant Disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557443/
Heim, E., Mewes, R., Abi Ramia, J., Glaesmer, H., Hall, B., Harper Shehadeh, M., Ünlü, B., Kananian, S., Kohrt, B. A., Lechner-Meichsner, F., Lotzin, A., Moro, M. R., Radjack, R., Salamanca-Sanabria, A., Singla, D. R., Starck, A., Sturm, G., Tol, W., Weise, C., & Knaevelsrud, C. (2021). Reporting Cultural Adaptation in Psychological Trials – The RECAPT criteria. Clinical Psychology in Europe, 3(Special Issue). https://doi.org/10.32872/cpe.6351
Jacobs, Z. G. (2021). Codifying Social Determinants of Health: A Gap in the ICD-10-CM. Journal of General Internal Medicine, 36(10), 3205–3207. https://doi.org/10.1007/s11606-021-06742-4
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Question 
Diagnosis of Neurodevelopmental and/or disruptive, impulse-control, and conduct disorders
PAST PSYCHIATRIC HISTORY: Marley’s mom does not report any psychiatric issues with Marley in the past. Prior to the birth of his youngest brother, his behavior was typical behavior for his peer group: video games, baseball, and softball.
Diagnosis and Assessment of Neurodevelopmental and Disruptive, Impulse-Control, and Conduct Disorders
SUBSTANCE USE HISTORY: None.
PAST MEDICAL HISTORY: The mother reports Marley broke his arm at 7 years old. The arm healed successfully. Marley had all his childhood shots, but she does recall her fear of his health early on when Marley was 2 2 weeks old and he came down with a spring cold.
FAMILY MEDICAL AND PSYCHIATRIC HISTORY: There was no significant information about the family history.
CURRENT FAMILY ISSUES AND DYNAMICS: As noted in History of Present Illness, Marley’s behavior began about 18 months ago after his younger brother was born. Marley has always been close to his mother but now defies her often. The family is of average income, Dad works as a computer programmer and Mom is a stay-at-home mom.
MENTAL STATUS EXAM: Marley presented as a casually dressed young male. He has a fluctuating mood and an anxious expression on his face. Motor activity appeared agitated. Mood was anxious alternating with hostility. The speech was normal. His affect was appropriate for his age. Marley is oriented to time, place, and person. He was able to state the season. Marley can name 3 different objects correctly (bed, apple, shoe).
SUICIDAL/HOMICIDAL ASSESSMENT: Marley denies any thoughts about hurting himself or others.
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