Case Study Of Billy's Case

Etiological/Precipitating and Maintaining Factors Throughout Billy’s case, there are many factors that both contributed to the onset of his diagnosis as well as maintained it. An important etiological factor present in the case was parent-child interactions, specifically between Billy and his mother. Li et al. (2017) confirmed that maternal involvement is an etiological moderator for the severity of ODD symptoms. The researchers specifically found that as a child’s perceived maternal involvement decreases, the ODD symptom severity increases. Billy’s mother, Jennifer, had limited maternal involvement early on his childhood as she had to work two jobs and only saw Billy at night when he was already asleep. However, this factor was most likely …show more content…
Patterson (2002) showed that an early childhood noncompliance and aggression coupled with a caregivers’ emotional and ineffective reactions can lead to increases in conflict that thus teach children how to be oppositional. This pattern is all too obvious in Billy’s case. Billy would intentionally commit actions that would outrage his mother in order to get her attention as her reactions were mostly to ignore him. When his mother responded to such an act, Billy gets positively reinforced that his outrageous behavior will guarantee him a responsive and thus increases the intensity of the behavior to elicit a response quicker. In the specific example described in the case, Billy’s mother reaction was hostile, slapping him and digging her nails into his skin, causing Billy to cease the behavior he was committing and cry himself to sleep. Through Billy ceasing his defiant behavior, Jennifer is negatively reinforced to believe that if she responds to his outrageous behaviors, he will stop doing them. This vicious cycle is summed up: Billy’s defiant behavior is met with a response from his mother (hostile or not) causing a reciprocal process of reinforcement, which causes Billy’s defiant behavior to increase and be maintained as a result. The cycle is then manipulated by Billy in his adolescence very effectively, maintain his calloused, unemotional traits which are crucial to his conduct disorder. When Billy wants to get out of his doing his homework, he engages in a similar cycle by mistreating his mother to elicit an emotional reaction from her, enabling him to leave the house, and thus maintaining the maltreatment of his mother and his resentment towards her as Billy deems her a “weak person”. A similar pattern of reinforcement occurred in school for Billy, specifically when his teachers would punish him by separating him from