RESUMO
The present case report presents the treatment of an adolescent with a diagnosis of F 91.1 conduct disorder, childhood-onset type. The treatment refers to the theoretical concepts of trauma-, psychodrama- and mentalization based psychotherapy. Before starting treatment several test diagnostic procedures were carried out. The psychotherapy targeted at changing the representations of attachment and at a process based development of healthy self-parts in the sense of mentalization. The therapeutic relationship took on a special position. The purpose of this paper is the question of how mental processes can be promoted, developed and integrated and to find out the importance of an integrative treatment approach.
Assuntos
Transtorno da Conduta , Mentalização , Adolescente , Criança , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/terapia , Humanos , PsicoterapiaRESUMO
Attachment Representations, Critical Life Events and ADHD in Boys at 6 to 10 Years of Age The importance of the attachment theory was repeatedly pointed out in the literature for understanding children with attention deficit hyperactivity disorder (ADHD) with regard to their emotional state. Symptoms of ADHD, like attention deficits, motor agitation and impulsivity are seen as risk factors for insecure attachment in the parent-child relationship. The acquisition of attachment representations in children with ADHD might help to describe - and individual classify - the syndromes of this behavioural disorder better. The aims of the present study are, therefore, the investigation of attachment representations and critical life events in boys with ADHD. We focused on boys only, since they are particularly prone to develop ADHD. Using the story-completion technique, we investigated whether boys with ADHD showed insecure attachment more frequently compared to boys without ADHD. 31 boys with ADHD at six to ten years of age were recruited in two different clinics. Of these, 29 % showed a secure and 71 % showed an insecure attachment representation. Within insecure attachment, the ambivalent attachment representation occurred most frequently (41 %). On average, we found 2.3 critical life events. The enhanced frequency of the ambivalent attachment representation indicates that ADHD might be linked to externalizing behaviour. The results support the hypothesis that ADHD is increasingly associated with insecure attachment. The binding theory is able to contribute to a better understanding of the emotional state in boys with ADHD.