Case Study: Examining Mental Disorders and Interventions for Overweight Hispanic Male

Introduction

In the presented case, the client is a Hispanic male named Carlos and is ten years old. He has come for therapy and diagnosis using the Diagnostic and Statistical Manual of Mental Disorders -5 will be made. Upon diagnosing Carlos, appropriate intervention will be used to ensure that Carlos can improve his emotional and physical health. Carlos has some presenting symptoms, and they provide essential information regarding his situation. First, Carlos does not want to go to school anymore; he is overweight, does not like the way he looks as he is fat. Another issue worth mentioning is that Carlos does not like it when his parents argue, and food seems to provide him with comfort from his problems. Besides, there are reports by his mother that can be used in coming up with the diagnosis. According to his mother, Carlos often cries a lot, refuses to take part in his family's events, and never feels like leaving the house. Carlos is also adding a lot of weight despite the fact that he only consumes a single meal each day.

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The DSM-5 Criteria for Assessment and Evaluation

Based on the presented information, the DSM-5 will assist in diagnosing Carlos. Carlos seems to meet the diagnostic criteria for the Binge-Eating Disorder. First, he engages in recurrent episodes, whereby he binges as characterized in two key ways. Carlos is not able to control his eating, and the one meal he takes each day is more than what other people consume during the same circumstances or period. Secondly, when Carlos is in a binge eating episode, he eats alone because of the embarrassment associated with the quantity of food that he is eating. It is evidenced by the fact that his mother found bags of chips and boxes of cookies under his bed. Also, when Carlos is binge eating, he becomes disgusted since it has led him to gain weight, and thus, he hates himself. Thirdly, Carlos is experiencing distress brought about by the binge eating (American Psychiatric Association, 2013). Finally, binge eating is not associated with anorexia nervosa or bulimia nervosa, and there is no inappropriate compensatory behavior. Carlos has a primary diagnosis of Binge-Eating Disorder.

Co-occurring Disorders

There is a likelihood of Carlos having co-occurring secondary diagnoses. He might also be depressed as characterized by some of the symptoms he is exhibiting. Based on his mother's report, Carlos has a depressed mood most of the time. He has even lost pleasure and interest in doing activities, and one such example is attending his family's events. Furthermore, Carlos is overweight, has feelings of worthlessness and guilt. It has reached a point whereby all the mentioned symptoms have caused distress that is clinically significant in important areas of his life, such as in school and at home. The identified symptoms are not present due to a medical condition or the use of a substance (American Psychiatric Association, 2013). It seems that Carlos might have a depressive episode since he does not meet the criteria to be diagnosed to be having a Major Depressive Disorder.

There is a likelihood that Carlos might have Social Anxiety Disorder is characterized by the symptoms that will be mentioned. He seems to be anxious about being in social situations such as family events and school since he might be the subject of scrutiny. Social phobia can be the reason why he hides food in his room and eats in privacy. A person that has SAD has a fear of being evaluated negatively, and Carlos deals with this by avoiding social environments (American Psychiatric Association, 2013). He fears social situations and does not want to try any activities such as hiking since it is an outdoor activity that can lead to scrutiny. Crying is another symptom of the disorder, and Carlos often cries when he is locked up in the bedroom. The SAD may have developed, and Carlos uses food as a coping mechanism.

Evaluation of Social, Environmental, Familial, Gender-Related and Cultural Factors

The evaluation of Carlos has provided insight into the cultural, gender-related, familial, environmental, and social factors that are a basis for his evaluation and assessment. In addressing the primary diagnosis, a familial factor may play a role in his diagnosis in that Carlos has grown up with older brothers that also love to eat a lot of food. It is also evident that in the environment where Carlos lives, food is always available, and he can even find a way of purchasing junk food. With regards to the secondary diagnosis of a depressive episode and social phobia, the fact that Carlos is being teased in the social environment at school may be the reason why he overeats as a way of coping with the stressor. Moreover, the arguments between his parents concerning him are negatively affecting Carlos, making him resort to binge eating. In terms of gender, males are considered to be the favorite children of the female parent. Consequently, Carlos seems to find solace in his mother, who might play a role in enabling his binge eating (Flores, 2000). Culturally, research suggests that Hispanics are among the leading cultures that are at risk of developing eating disorders.

Other Factors Affecting the Evaluation

It is worth mentioning that Carlos is the last born in his family. He seems to be highly favored by his mother as he is always at home with her, thus receiving a lot of attention. The mother might give Carlos more food than is required so as to compensate for the problems he is experiencing at home and at school. Carlos seems to be more comfortable with the mother, who acts as his defense against his father. The father appears not to be pleased with his son being overweight and not living an active life despite his efforts in trying to convince him to do so. There are many factors that are responsible for making Carlos develop the provided diagnoses.

Physical and Emotional Concerns Involving the Client

Some concerns should be prioritized with regard to the client's emotional and physical health. Physically, Carlos is overweight, and if he continues with unhealthy eating habits, it might have dire consequences in the future, such as the development of lifestyle diseases. The lack of initiative to engage in exercises is another source of great concern as he prefers to live a dormant life that does not involve exercising. Genetics also has some influence on his weight gain since his mother's side of the family has obese individuals. With regard to his emotional health, suicide and increased mortality rates are other concerns. Carlos is experiencing emotional distress from being teased by his peers, and this has made him have negative feelings towards himself. He has isolated himself from others, and engaging in emotional eating is affecting his mental health. It is by going for therapy that his emotional concerns can be addressed (Flores, 2000).

The Role of a Pediatrician in Addressing the Client's Physical Concerns

A pediatrician plays an essential role in coordinating psychiatric and psychosocial aspects of care, providing nutritional rehabilitation, and the management of any medical complications (Hilbert, Hoek & Schmidt, 2017). The services provided by the pediatrician will ensure that Carlos receives a holistic treatment in that he will benefit from treatment targeted towards his physical health. Therefore, the role of the pediatrician, in this case, is quite crucial as he or she is a provider of the much needed medical management associated with obesity-related issues.

Evidence-based Individual and Family Therapy Modalities

Family dynamics are present, and evidence-based family and individual therapy modalities can be useful in dealing with the issues that affect Carlos together with his parents. Interpersonal Psychotherapy, Maudsley Family Therapy, and Cognitive Behavioral Therapy are the most established interventions in treating binge disorder among children Peterson, C., (Becker & Treasure & Shafran & Byrant, 2016). It is vital to ensure that Carlos has individual sessions with the therapist, whereby the CBT and IPT interventions will be beneficial. In other sessions, Carlos will be joined by the parents, and the Maudsley Family Therapy is the modality to be incorporated (Lock, 2015). In this case, I would also recommend couples counseling for his parents as they are indicators that their relationship is having difficulties.

Conclusion

The presented case has provided insight into important issues that come about when handling patients. Consequently, the person providing the therapy should be able to adapt to the client's cultural background in order to provide comprehensive care. In the Hispanic culture, familism is quite an important factor, and they do what they can to protect their families. It means that Carlos's parents will be accommodative to therapy as they want to assist their son, who is a member of their family. The issue facing Carlos seems to be bringing about a strain on the parent's relationship, as evidenced by arguments and disagreements. In the long run, Carlos is sure to benefit from the therapy sessions that will address the issues that have come about in the assessment and evaluation.

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed). Arlington, VA: American Psychiatric Association.

Flores, G. (2000). Culture and the patient-physician relationship: Achieving cultural competency in healthcare. The Journal of Pediatrics, 136 (1), 14-23.

Hilbert, A., Hoek, H., & Schmidt, R. (2017). Evidence-based clinical guidelines for eating disorders: International comparison. Current Opinion in Psychiatry, 30(6), 423-437.

Lock, J. (2015). Update on evidence-based psychosocial treatments for eating disorders in children and adolescents. Journal of Clinical Child Psychology, 44 (5), 707-721.

Peterson, C., Becker, C., Treasure, J., Shafran, R., & Byrant. (2016). The three-legged stool of evidence-based practice in eating disorder treatment: research, clinical, patient perspectives, BMC Medicine, 14 (69), 34-45.