Children with Multiple Mental Health Challenges by Landy Sarah;Bradley Susan;

Author:Landy, Sarah;Bradley, Susan;
Language: eng
Format: epub
Publisher: Springer Publishing Company, Incorporated
Published: 2013-08-15T00:00:00+00:00

Case Study: Ethan

Ethan’s parents were caring, high-functioning people deeply concerned about their son and struggled to find suitable treatments for him. His presentation seemed to be a combination of an uninhibited temperament from early on, difficult early experiences with both parents, and anxiety and depression over his current situation. These factors are summarized below:

Ethan had a difficult, “temperamentally exuberant” personality with low fear of new situations and impulsive approach behavior.

Maternal depression and consequent trauma might have resulted in greater right-brain activation and hemispheric asymmetry. This could also have contributed to the storing of implicit trauma memories that could be triggered and result in aggressive outbursts at certain times.

Ethan had insecure/disorganized attachment with both parents from early on. His attachment could best be described as disorganized, with a tendency to initially “approach” and then “move away” and become angry and frustrated with both parents.

He had a negative sense of self and others that might have developed because of the punitive discipline that he had received from his father and the early trauma.

Ethan probably had problems with development of the social brain, including the amygdala and parts of the prefrontal cortex (e.g., orbital medial prefrontal cortex and anterior cingulate cortex).

He had lower autonomic reactions to rewards and punishments, making discipline less effective.

There was inconsistent parenting by both parents, and Ethan needed more attachment-based discipline from early on. This had worsened before the referral.

There was a possible genetic risk, with both his mother and maternal grandmother having had chronic anxiety and depression. Also, Ethan’s paternal grandfather might have had ADHD; Phillip often talked about how his father was an alcoholic and cruel and at times violent toward his mother.

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