Using the below case study, answer the following:

1. brief demographic information about client and their presenting problem/s

2. use the DSM5-TR classification system to make a diagnosis, include diagnostic features, subtypes, specifiers, severity, contributing psychosocial and environmental factors using the ICD-11-CM, and Z codes

3. Conduct a differential diagnosis based on the DSM5-TR

CASE STUDY

Barry Simpson is a 6-year-old male, referred by his biological mother (Ms Simpson). Barry is in the first grade at school and started school 8 months ago. Ms Simpson stated that the reason she was coming to the clinic was to get help for her son who was constantly getting into trouble at home and at school.

At the interview with the psychologist, Barry and his mother were present. Barry seemed shy, however, he was polite and answered questions after receiving coaching from his mother. He appeared anxious as he fidgeted in his chair with little eye contact. Barry stated he did not like his teacher because his teacher yelled at him in front of his classmates and sent notes home to his mother. This was because Barry does not follow class rules and because he gets angry at the teacher. Barry has one friend at school, John. Barry yells at the other kids when they do not let him play with them. Barry said, "My mother and father yell at me, sometimes they smack me and I have to go to my room when I do not do as they ask." Barry said he hates when he has to present at show and tell time as he worries that the other kids will make fun of him.

At a separate interview with the psychologist, Ms Simpson stated that Barry argued a lot with her and his father, and refused to obey their requests and instructions, especially to complete homework and have a bath. When Ms Simpson said Barry often loses his temper and throws a tantrum, particularly when she said 'no' to his requests. He then screams and yells until he gets what he wants. Barry's mother and father often gave into Barry's demands for peace. Barry also deliberately annoys his sister. Ms Simpson stated Barry seems to be easily annoyed. He has no problems with adaptive behaviours such as dressing and eating. She stated, "My husband and I find Barry to be a very difficult child to control at home and in public places, like shopping centres." Ms Simpson said that Barry's behaviour in this regard had not changed much since preschool (1 year ago) when he would get into trouble for not following the rules, his angry outbursts and throwing tantrums. The teacher reports that he also annoys other children on purpose and he does not wait his turn when waiting in line to go to the pool. Ms Simpson said Barry is rude and butts into games when his brother and sister are playing. Barry also blamed his older brother when he did not complete her chores, e.g. 'He stopped me from doing the chores.'

Mr Simpson earns an average income and Ms Simpson is unemployed. Due to financial difficulties, currently, the family live in a housing commission house with Barry and his older sister and brother. Ms Simpson also reports that neither she or husband nor any members of their extended family suffer from any psychological disorders.

Ms Simpson gave permission to the psychologist to speak with school staff about Barry. Barry's teacher, Ms Smart, reported "Barry is in jeopardy of being suspended from school for his refusal to follow rules and for his angry outbursts towards me." Ms Smart stated that Barry's academic performance was below average but not failing. She stated that whilst his writing was poor, he understood and completed reading and math assignments when motivated to do so. She also noticed that Barry never wanted to have his turn at show and tell, he seemed anxious to talk in front of the class.

The school psychologist, Mr Smith stated that Barry's tested intelligence level was within the normal range, therefore deferring a diagnosis of learning disorder. He stated that Barry was good at sports, but had difficulty making friends at school. Mr Smith thought Barry required behaviour modification to control his disruptive behaviours. The family doctor stated that Barry's physical health was good and there appeared to be no medical condition to cause Barry's behaviours.