Disruptive Mood Dysregulation Disorder and Anxiety

Topic: Psychiatry
Words: 1226 Pages: 4

Narrative Summary

When I approached Aron for the first time, he was uneasy and resistant since he could not talk and explain himself in our first interaction. Later, when I approached him for the second meeting, he started opening up and could, at times, respond positively to my questions. However, in both interactions, Aron was disturbed and always felt depressed as a person undergoing psychological disorders. In our second meeting, I engaged Aron with some little exercises and games as we shared the experience. He developed an interest in the game we played together and started enjoying it. In addition, his responses also became very favorable in our conversations.

However, he could show some signs of quietness and a disturbed character, which informed me about his challenges. My impression was that he was undergoing physical and mental disturbance attributed to his unusual behaviors (Hendrickson, Girma, & Miller, 2020, para. 3). In addition, I was made aware of his life experiences when he finally opened up to me the moment I engaged him so closely. From his narrations, Aron was psychologically disturbed, a condition that originated from his family line. This narration prompted me to engage his parents in some sessions, which confirmed how he had been suffering long since his childhood.

From the presentations of the two interactions with Aron, the sleep disorders at times were shown, and he could become irritable by some of the questions I asked him. The behavioral displays from Aron’s reactions became a concern, and I established a plan to engage him fully with his parents and other siblings so that I could implement rehabilitating his condition. From the responses of his parents and siblings, I generated some reasons for his behaviors since most of them confirmed that he had undergone previous psychological disturbances at an early age.

DSM–5 Diagnosis and Assessment

After considering Aron’s behaviors and conditions, I have diagnosed a disruptive mood dysregulation disorder (ICD 296.99) as a primary disorder and a parent-child relationship problem (ICD Z62.82) as a secondary diagnosis. This judgment has been based on the prevailing conditions of Aron and his interactive behaviors with his family members and the people around him. After the assessment, I ascertained that Aron was experiencing severe sleeping disorders characterized by depression and moderate anger (Simone, Katharina, Argyris, Michael, & Hong, 2020, para. 1). In addition, Aron has been irritable in most situations which could extend to severe levels at times.

Besides, Aron has also faced sleeping difficulties with some depression-related challenges during our interactions. These behaviors conclude that Aron has been diagnosed with disruptive mood dysregulation disorder with severe sleep-related problems, irritability, anger, and some anxiety. Since Aron has a depressive problem, I adopted a plan to assist him in overcoming some of these problems naturally since they can easily be cured by nature healing (Haller, Stoddard, MacGillivray, Stiles, & Perhamus, 2018, para. 3). Besides the disruptive mood disorder, I can also assume that Aron is experiencing stress management-related problems since he feels lonely and, at times, emotionally disturbed after conversations with friends and siblings in the house.

However, I ruled out the stress-related issues since the signs shown by sleeping disorders exceeded their key symptoms. Aron usually experiences sleep disturbances and is brutal and rude when interacting with people. The assessment criterion was based on Aron’s symptoms and general signs and how regularly he experiences these problems (Pan & Yeh, 2019, para. 1). The manifestation of the key symptoms of depressive disorders enables me to believe that Aron is a client of this diagnosis; hence should be treated for the condition rather than offered treatment for the other minor problems he shows their signs. I have focused mainly on the complex level of the problems presented by Aron from the DSM-5 manual recognized internationally by medical experts. The manual allows for critical examination of the condition regarding the facts and the physical examination of Aron. However, the assessment I have conducted is not limited to other choices of examining the prevailing conditions of a given client exhibiting these signs and symptoms.

Theoretical Orientation and Application

In dealings with Aron and his family members, I have adopted a family system orientation since it depends on each family member and can be possibly impacted by their actions. The key elements in family system orientation include characteristics, interactions, functions, and the life cycle. The siblings share the same characteristics and interact freely in their family, making Aron fit in this group. In this orientation, Aron controls the mood of his family and their daily activities since they share the same qualities in the family setup. Therefore, to gain more knowledge about Aron, I involved his parents since they have vital information about their family and can offer the security of information when needed in my approach.

In addition, Aron’s parents are very free to share their thoughts and can easily be consulted. Aron is part of this family through his continued behaviors which portray misbehaviors. I, therefore, consider him as part of this family line since he contributes to the family’s growth and development. Aron is faced with issues of distrust and has depressive problems such as chronic irritation and anger; hence understanding his character through the family system orientation aided my understanding of how best I could counsel him. Aron is a very sensitive client since he does not want to open up about his character; hence, I am very careful when considering the time of interactions and the questions I ask him to ensure that I get the best advice he needs.

By employing the family system orientation, my client would likely open up about his family stories, and he would present his challenges in the best way possible for my counseling program to be easy. The aim of conducting this counseling for Aron is to assist him in changing his behaviors and enabling his family to change their perception of how they view him in their family setup. Besides the family system orientation, I adopted a child-centered counseling theory that enabled me to understand the challenges Aron faces before developing plans to assist him. I will develop a high level of interpersonal relationship with Aron to enable me deeply understand his character and offer any assistance to his problems.

Therefore, adopting the child-centered theory approach enables me to engage him by employing some strategies like playing and involving him in most of my activities so that he gets to enjoy the sessions. I also employed the human behavior approach of counseling since it enabled me to critically understand the behavior change that Aron has undergone since his childhood. Through this human behavior approach, I involved Aron’s parents in enabling me to understand the reasons behind his current behaviors and how he has grown with this problem throughout his lifetime.

The approaches I adopted were collaborative and enabled me to deeply understand Aron’s challenges before the best strategy to counsel him. In addition, these approaches assist me in offering future methods of assisting him in case of other challenges besides the current problem he is experiencing. I would help Aron learn how he can control his moods and enable him to grow with a view of changing his behaviors through these approaches I have implemented as they develop ways of handling the challenges that Aron is experiencing for long periods.


Haller, S., Stoddard, J., MacGillivray, C., Stiles, K., & Perhamus, G. (2018). A double-blind, randomized, placebo-controlled trial of a computer-based Interpretation Bias Training for youth with severe irritability: A study protocol. MA Trials, 19(1):626.

Hendrickson, B., Girma, M., & Miller. (2020). Review of the clinical approach to the treatment of disruptive mood dysregulation disorder. L.Int Rev Psychiatry, 32(3):202-211.

Pan, P., & Yeh, C. (2019). Irritability and maladaptation among children: The utility of Chinese versions of the affective reactivity index and aberrant behavior checklist-irritability subscale. J Child Adolesc Psychopharmacol, 29(3):213-219.

Simone, H., Katharina, K., Argyris, S., Michael, C., & Hong, B. (2020). The clinician affective reactivity index: Validity and reliability of a clinician-rated assessment of irritability. Behavior Therapy, (51): 283–293.

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