Pediatric Genogram Assignment Paper
Pediatric Genogram Assignment Paper
As pediatric care has advanced over the years, the perspective of the system to utilize genograms remains an evocative way of appreciating a family’s complexities (D’Onofrio & Emery, 2019). For instance, studies show that family structure can greatly impact the mental health of children impacting their development which has profound long-term consequences. By using a genogram, it is necessary to identify disruptions in family structure their impact on the mental health of the child. However, not all disruptions are of equal intensity. Most of the time, behavioral and emotional problems occur in families which are disrupted by divorce and separation as compared to other forms of disruptions such as when a parent dies. Several factors have been pointed out to increase the risks of abuse for both the caregiver and the child. Such factors include depression, young age, substance abuse, poor housing, poverty, and toxic neighborhood among others. Additionally, caregivers exposed to abusive childhood tend to be more aggressive with their children to the point of affecting their mental health. The above pediatric genogram demonstrated the family dynamics of a 9-year-old patient, and how they contributed to her oppositional defiant disorder.
Family Dynamics
L.P is a 9-year-old female patient presenting with signs of oppositional defiant disorder. She comes from a family of 4, but her father divorced her mother when she was 4 years old and remarried. Ever since she has been living with her older brother and mother in a small house in the suburbs. Her mother is 41 years old and works at a nearby supermarket, and gets enough money to take care of the two children. She however receives financial support from their father. She is very religious and has managed to raise both her children as Christians. She is the only child, with both parents alive and healthy.
L.P’s father, on the other hand, is 47 years old. His mother died three years ago from myocardial infarction. His father is still alive at the age of 78 years old with bipolar affective disorder. His parents had a hostile relationship and would fight in his presence. Coming from a humble, background, he has struggled most of his life, which contributed to his bitterness. He got married at a young age and was quite reluctant to start a family due to their low social status. Ever since the birth of the first child, he started distancing himself from the family. He would fight with his wife to the point that it turned out physical in the presence of the children. He has been abusing both the two children by shouting at them. About four years ago, his wife got fed up and filed for a successful divorce. Even though he supports his family financially, he spends less time with the children and focuses on his other family.
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Impact on Mental Health
Most of the patient’s family dynamics negatively impacted her mental health leading to the oppositional defiant disorder. For starters, she was emotionally abused by her father at a young age. She also witnessed quarrels and physical fights between her mother and father. Another stressor in the patient’s life that contributed to her condition is the recent change in the living situation when his father moved out after the divorce and immediately started a new family. She started displaying oppositional defiant symptoms after her parents divorced, which means that this is the main stressor that significantly impacted her mental health. Studies show that children from divorced families normally experience additional externalizing problems like delinquency, conduct disorder, and impulsive behavior as compared to children with two-parent families (Auersperg et al., 2019). Normally such children tend to experience more conflict with their peers after the divorce. They will also display poor academic performance especially when the parents divorced when they were less than 5 years old, just like in the case of L.P (Hadfield et al., 2018). Additional vulnerabilities in the patient’s family structure which contributed to poor mental health include a family history of mental disorder as seen with the paternal grandfather who was diagnosed with BPAD, and low income or poverty.
Conclusion
The pediatric genogram described above demonstrates a family structure with several deficits affecting the mental health of children. Studies show that defective family structures can negatively impact the mental health of a child at a young age, which can undermine their well-being throughout their lifetime. For instance, the 9-year-old patient was diagnosed with oppositional defiant disorder, which may have resulted due to several stressors and vulnerabilities within the patient’s family structure. Such stressors include abuse, divorce, and recent changes in living arrangements. The vulnerabilities in the patient’s life which negatively impacted her mental health include poverty, poor living standard, and family history of mental illness among others. Such factors are crucial in formulating the most effective care plan for the patient.
References
Auersperg, F., Vlasak, T., Ponocny, I., & Barth, A. (2019). Long-term effects of parental divorce on mental health–A meta-analysis. Journal of Psychiatric Research, 119, 107-115. https://doi.org/10.1016/j.jpsychires.2019.09.011
D’Onofrio, B., & Emery, R. (2019). Parental divorce or separation and children’s mental health. World Psychiatry, 18(1), 100. DOI: 10.1002/wps.20590
Hadfield, K., Amos, M., Ungar, M., Gosselin, J., & Ganong, L. (2018). Do changes to family structure affect child and family outcomes? A systematic review of the instability hypothesis. Journal of Family Theory & Review, 10(1), 87-110. https://doi.org/10.1111/jftr.12243
Create a GENOGRAM with explanatory narrative of a pediatric or adolescent patient, including family dynamics and impact on mental health
the genogram for a pediatric or adolescent patient and write a narrative explaining the relationships and the impact they have/had on your patient’s mental health and life trajectory.