Internalizing Attention Deficit Hyperactivity Disorder

Internalizing Disorders
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1 Describe the clinical situation in detail. (Who was it, when did it happen, what happened, what caused it to happen, where did it happen, how did it happen).
This is a case of E.D., a 17-year-old female patient diagnosed with attention deficit hyperactivity disorder (ADHD) last month. The patient came with her mother to the psychiatric clinic for consultation secondary to complaints of poor academic performance due to poor concentration, poor listening skills, inability to follow instructions, and loquaciousness during class hours. The process was explained before the interview, and the mother’s and the patient’s consent were obtained. The mother was first asked to wait outside as the interviewer assessed the patient.
During the interview, the patient cannot focus on the interviewer’s questions and keeps on interrupting and shouting at the former. Moreover, the patient refuses to tell her insights and refuses to talk about her daily activities, most of which she has forgotten already. Due to this, the interview did not run smoothly as the interviewer had difficulty connecting the statements and asking follow-up questions.
2 What feelings, prejudices, and biases did you experience during your clinical experience?
As clinicians, we are trained to be calm and understand every situation as we work in an environment that necessitates maximum tolerance. However, the feelings, prejudices, and biases may still be present despite such pieces of training and individual efforts. In this case, the apparent primary emotion was exasperation due to the difficulty in communication. As the interviewer, it is necessary to direct and control the situation to obtain the vital information to make a diagnosis, differential diagnoses, and eventually, the treatment plan. However, the patient kept interrupting and suddenly bursting out, which made the interview go back to square one. Another emotion that was central during the interview is sadness because the patient told about how the condition affected her social standing in the community, especially in their school, where she is branded as a weird individual and often bullied. Due to this, she has only a few friends whom she does not even know if she can trust.
From another person’s point of view, if I were not a clinician, I understand the bias that the patient would be perceived as a nuisance not just to her peers but even to her family. This is because the patient is uncontrollable, and it might be challenging to have an exchange of information.
3 How did you manage your anxieties, feelings, prejudices, and biases?
Unconscious and implicit bias affect the clinician’s assessment and judgment of the patient’s case. It is essential to train oneself and ask for help from the organization to mitigate the effects of implicit bias. Some individual strategies reflect personal prejudices and endless inquisitions about societal stereotypes. Conversely, the organization should also make an effort to help the clinicians manage such feelings and prejudices by providing diverse training and leadership commitment to c...