Conceptual possibilities of making a dual diagnosis of conduct disorder and Asperger's syndrome in children.

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2010-05-31T06:41:44Z

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Jamieson, Andrea

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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.

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