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Childhood Diagnosis Scenario: Depression and PTSD

Kelli is a 6-year-old who lives in a dangerous neighborhood, goes to an under-funded, crowded school, and lives in poverty at home with her single mother and two siblings. Her father was mostly absent from her life, but Kelli knows the father recently was shot in the neighborhood and paralyzed. Kelli's mother spends a lot of time at work. Recently, teachers reported that Kelli is distracted, fails to complete work, argues with peers, and withdraws from many activities. Kelly seems constantly irritable or sad, either clinging to the teacher or refusing to talk to her. Kelli often tantrums when asked to do things or play on her own. Mother and teacher report that Kelli rarely smiles or seems to enjoy things, puts herself down (e.g., says nobody likes her or that she is ugly), and seems to shut down if someone mentions her or another child's father.

a. What diagnoses might you consider for Kelli?
b. What other information would be helpful in this case?
c. Use attachment theory to explain Kelli's mood and behavior.

Solution Preview

While Kelli is likely susceptible to depression in the light of her ongoing life circumstances, what strikes me most is that her teacher is reporting recent changes in her behavior. The irritability, withdrawal and separation issues suggest Post-traumatic Stress Disorder, triggered by her father being shot. You might want to look at a site like

http://www.forests.com/ptsdchil1.html

which describes briefly some of the symptoms of PTSD in children. They include problems in the following areas:

peer relationships
relationships within the ...

Solution Summary

A diagnosis is proposed for an inner-city girl who is displaying recent behavior changes: withdrawal, sadness, irritability, tantrums. Suggestions for useful additional information are offered, as well as an interpretation of her behavior according to attachment theory. Prognosis and suggestions for intervention are proposed. This solution is 328 words.

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