Conceptual possibilities of making a dual diagnosis of conduct disorder and Asperger's syndrome in children.
Date
2010-05-31T06:41:44Z
Authors
Jamieson, Andrea
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Very few studies have addressed the possible dual diagnosis of conduct disorder (CD)
and Asperger’s syndrome (AS) in children and as such there is little evidence to either
support or dispute such a dual diagnosis. This research explored psychodynamic
professionals’ opinions on the possibility of the dual diagnosis of CD and AS in children
by considering how these clinicians conceptualise each disorder in terms of attachment
(Bowlby) and mentalisation (Fonagy) theory, and whether they believe an overlap can or
cannot exist diagnostically and/or theoretically. The research drew upon four clinical
psychologists and four child psychiatrists’ experiences of these disorders in their clinical
practice. Semi-structured interviews were utilized and the clinicians’ responses were
analysed using thematic content analysis. The results indicated that the clinicians
understand each disorder inversely where CD is related to impaired attachment and AS to
impaired mentalisation and that only superficial diagnostic and theoretical overlaps exist
between the two disorders, indicating that AS and CD are not a single construct. The
possibility of dual diagnosing CD and AS is understood by some clinicians to occur due
to impaired attachment or if a child with AS is exposed to additional risk factors often
implicated in the development and persistence of CD. However, some clinicians
highlighted that a dual diagnosis is not possible as a child with AS does not have the
biological ‘wiring’ to engage in behaviour that children with CD manifest and that a dual
diagnosis is precluded for children with AS as diagnostic systems do not allow for such a
possibility.