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Option 1 Paper Abnormal Psychology
Name:
Date:
Title page (5 points)
Reference page (10 points)
Citations (20 points)
Punctuation, spelling, word usage, complete sentences,
Sentence construction, etc. (10 pts.)
Summary of Paper; Does it give a good explanation of
The disorder and its treatment. (30 points)
Thesis (10 points) Paper introduced a topic that was
appropriately researched in the paper.
Introduction /outro (15 points) Was there an adequate
Introduction to the paper, and was there a good final paragraph
or discussion.
Total points;
Comments
(100 maximum)
PAGE
1
My Title
DOCVARIABLE SH5SectionTitleRunning head: RESEARCH
PROCESS
1
DOCVARIABLE SH5SectionTitle
The Research Process
James L. Becker (your name here)
In partial Fulfillment of
Abnormal Psychology Class (section #)
James L. Becker, Instructor
Pulaski Technical College
Date
NOTE: PUT YOUR TITLE WHERE I HAVE MY TITLE - The
Research Process. ALSO PUT In the
Running Head: SHORT TITLE (SHORT TITLE IN CAPS).
Subsequent pages put
SHORT TITLE in upper left margin (1 inch) and page number
in right margin.
USE NEW TIMES ROMAN 12 FONT.
Save your file as Word 97-2004 so I can open it.
In this brief tutorial I want to explain how to get underway with
your research process. I also want your title page to be set up
in a similar fashion, and the Reference page to be set up in
exactly the same way. I will demonstrate how to cite some
references that you will be using in your research process.
Begin your research process by selecting a disorder. After
selection of your disorder, go to your textbook in order to
research that particular disorder. Make thorough notes from
the book. Write down your source so you can use that to make
your reference properly. My advice is to put quotation marks
around everything that is word for word from the book along
with the page number. This will help to eliminate the
possibility of plagiarism. Later, when you go to write your
paper, you will know exactly what you copied word for word so
you can try to put it in your own words, or if you need to quote
something, you will have the page number at your fingertips.
At the end of this discussion I have a sample of how to
reference your textbook. As you read your textbook or any
other source, if you read something that you want to look into
more as a thesis, look that reference up in the back of the book.
If it is a journal, we may have it at the library, and if not, you
can access it through the Interlibrary Loan (ILL) program. If
you wait until the last minute, this will eliminate this option.
The next step is to go to the DSM-IV-TR (2000) which we have
in our library database. I will give you step by step
instructions in order to do this.
Step I: Go to the Pulaski Technical College website at
http://www.pulaskitech.edu
Step II: Click on “Library”
Step III: Find “Articles & More” Click on Databases by
Subject.
Step IV: Click “Psychology”
Step V: Click on Psychiatry Online. At the top of this page
you will find DSM-IV-TR. There are other sources to explore
here, but go to DSM-IV-TR first. Click copyright, citation on
your right and that will give you the information for the
reference page. I will reference the DSM-IV-TR (2000) on the
reference page of this document. Go to your disorder and
again make notes that you will need to later write your paper.
After you have researched the DSM-IV-TR (2000), go back to
the page where you first found the DSM-IV-TR (2000). Scroll
down until you get to “Textbooks”. Notice that there are three
books about Psychopharmacology. If you wish to later research
medication treatment of a particular disorder, these are
wonderful sources, but for now click “Textbook of Clinical
Psychiatry (Hales ,Yudofsky, & Gabbard (Eds.) ,2003). Click
the citation link to note how to cite this as a reference. I have
listed this in the reference page so you can see how to do this.
Go to the chapter with your disorder. Note that some Chapters
have authors, so in your reference you would put the Chapter #
and title and author of that particular chapter. I will put one in
the reference so you can see how it is supposed to appear. I
will cite Chapter 10, Mood Disorders to illustrate this.
DOCVARIABLE SH5SectionTitle
DOCVARIABLE SH5SectionTitle
References
Factitious 1
RUNNING HEAD: FACTITIOUS DISORDER
A Great Deceiver: Patients with Factitious Disorder
In partial fulfillment of
Abnormal Psychology Class (Summer Extended Online)
Instructor
July 12, 2009
According to legend, Baron Karl Friedrich Hieronymus von
Munchhausen enjoyed telling larger-than-life war stories
pertaining to his time spent fighting for the Russian army
(Kaplan and Sadock, 2005). For the purpose of history and
classification, Hales and Yudofsky (Eds. 2003) make note of
this particular story for two reasons; first, it is an early account
of a patient with a strange psychological disorder who has a
history of peregrination intertwined with fabricated stories and
wounds, and second, factitious disorder was once referred to as
Munchausen Syndrome, named after the Baron and his elaborate
wartime stories (Hales and Yudofsky, 2003). In 1951, a British
physician, Richard Asher, coined the term Munchausen
Syndrome (Hales and Yudofsky, 2003). In response to this
breakthrough, Dr. Asher stated:
Here is described a common syndrome which most doctors have
seen, but about which little has been written. Like the famous
Baron von Munchausen, the persons affected have always
traveled widely; and their stories, like those attributed to him,
are both dramatic and untruthful. Accordingly, the syndrome is
respectfully dedicated to the baron, and named after him
(Kaplan and Sadock, 2005, pg. 1830).
Baron von Munchausen played a crucial role in the interest with
this particular disorder, but earlier accounts have been noted as
well, using various names. Hector Gavin, a Scottish military
physician, wrote an essay in 1838 (Kaplan and Sadock, 2005)
distinguishing between malingering soldiers, who are
attempting to avoid further combat in the Napoleonic Wars, and
the soldiers who purpose is “to excite compassion or interest”
or “experience an unaccountable gratification in deceiving their
officers, comrades, and surgeons” (Kaplan and Sadock, 2005,
pg. 1830). In 1890, Jean-Martin Charcot uses the term mania
operative active when retelling the account of a young girl in
search of a surgeon to attend to her ailing knee. After several
attempts, she was able to find a surgeon who would amputate
her leg, but the cause of her pain had no organic basis (Kaplan
and Sadock, 2005). Although cases of factitious disorder can be
traced back to the second century with documented cases by the
Greek physician Galen (Kaplan and Sadock, 2005), its true
diagnosis is further complicated by comorbid psychological
disorders and intentionally produced physical symptoms. These
symptoms are mixed with a deceptive representation and
medical history. This results in an inaccurate estimation of the
prevalence of factitious disorder, no definitive treatment, and
difficulty in determining a cure. Altogether, the symptoms lead
to a chronic, lifelong cycle of wandering from doctor to doctor,
unnecessary medical procedures, and medical conditions
unintentionally suggested by these physicians.
According to Barlow and Durand (2005) classify factitious
disorder under a broader group, somatoform disorders. The root
word soma means body; therefore people with a somatoform
disorder include those who have physical symptoms, but no
cause of the medical condition can be determined. Somatoform
disorders tend to be quite difficult to detect and treat, according
to Barlow and Durand (2005), because the physicians and
clinicians have three tasks to complete; first, they must rule out
the physical complaint, second, mental health professionals rule
out other psychological disorders in order to properly label the
type of somatoform disorder they are presented with, and third,
the clinician must have a thorough understanding of the
patient’s culture. With all somatoform disorders similar in
presentation, they are set apart by the various motives or
rewards; factitious disorder falls somewhere between
conversion disorder and malingering (Barlow and Durand,
2005). The DSM-IV-TR (2000), states that “factitious disorders
are characterized by physical or psychological symptoms that
are intentionally produced or feigned in order to assume the
sick role” (pg. 513). They desire to always be the designated
patient. There are three subtypes that will be discussed later.
According to this definition, factitious disorder is set apart from
malingering; with malingering, “the individual also produces
the symptoms intentionally, but has a goal that is obviously
recognizable when the environmental circumstances are known”
(DMS-IV-TR, 2000, pg. 513). Some possible motivations for a
malingerer could include financial gain, not returning to
combat, avoiding jury duty or other legal matters, or getting out
of work (Barlow and Durand, 2005). A person with factitious
disorder simply wants to “assume the sick role” and the
attention that accompanies it (Barlow and Durand, 2005).
There are three subtypes of factitious disorder, according to the
criteria in the DSM-IV-TR (2000); first, with predominantly
psychological signs and symptoms, second, with predominantly
physical signs and symptoms, and the third, with combined
psychological and physical signs and symptoms (pg. 514-515).
Factitious disorder with predominantly psychological signs and
symptoms is simply when a patient presents with a mental
disorder, such as “depression, suicide, memory loss,
hallucinations or delusions, PTSD (post-traumatic stress
syndrome), or a dissociative disorder” (DMS-IV-TR, 2000, pg.
514). When predominantly physical signs and symptoms are
associated with the disorder, common medical conditions can
include “feigning/intentionally producing, exaggerating, or
fabricating infection (e.g. abscesses), aggravating an existing
wound from healing, pain (e.g. abdominal), hypoglycemia,
anemia (e.g. bloodletting), rashes, seizures, dizziness, blacking
out, vomiting, diarrhea, fevers, or symptoms related to an
autoimmune/connective tissue disease” (DSM-IV-TR, 2000, pg.
514-515). The third subtype is simple; both psychological and
physical signs and symptoms are present with neither of the two
dominating (DSM-IV-TR, 2000). Defining factitious disorder is
an easy task, but the difficulty begins when diagnosing a
patient, determining the treatment, and providing history of the
disorder.
Before being able to address appropriate diagnosis and
treatments, it is best for people to have sufficient knowledge of
the history of this deceptive psychological disorder. Because of
the deceptive nature of this disorder, accurate estimates of
epidemiology and prevalence are difficult to calculate (Kaplan
and Sadock, 2005). Factitious disorder patients have a tendency
to leave the hospital once their medical problems are
determined to be fabricated or there is supporting evidence that
the symptoms were intentionally produced, leaving the patient
feeling embarrassed or humiliated (Pasic, Combs, and Romm,
2009). Not only does the patient fleeing the scene lead to no
help and a greater chance of no cure for their problem, it causes
another issue for researchers who are trying to determine the
prevalence. It is thought that with their repeated roaming from
one physician or medical facility to another as a common
characteristic, some patients may be counted more than once in
a location which may lead to an overestimation. Factitious
disorder may be underestimated because the patients are fleeing
when found out rather than seeking the help they need (Hales
and Yudofsky, 2003, Epidemiology).
Of the known cases, the prevalence differs with each hospital,
various studies, and depending on the specialty of the physician
(Hales and Yudofsky, 2003). As mentioned by Pasic, Combs,
and Romm (2009), the majority of patients tend to be women
between the ages of 20-40 and are “often employed in the
medical field as nurses, medical technicians, or other health-
related jobs” (pg. 63). Several different studies have been
performed in order to calculate a potential prevalence rate; they
can be found in Kaplan and Sadock’s Comprehensive Textbook
of Psychiatry, Eight Edition, Vol. I, on page 1831-1832 or
Hales and Yudofsky’s Textbook of Psychiatry. However,
according to the DSM-IV-TR (2000), “the best data indicate
that, within large general hospitals, Factitious Disorder is
diagnosed for about 1 % of the patients on whom mental health
professionals consult” and is “greater in highly specialized
treatment settings.” (pg. 516). Not only is this a rare disorder,
it can be very puzzling to researchers and clinicians.
Now that the complicated task of determining prevalence has
been addressed, one can focus on the information that is
available to clinicians and physicians. Before discussing the
complicated issues of diagnosing a patient with factitious
disorder, understanding potential causes may be helpful in
narrowing the affected population. Of the documented cases, a
common factor is present in a majority of the patients. After
much research, Kaplan and Sadock (2005) note that “the
etiology of factitious disorder is not known” but they can
associate a list of possible childhood events that may be a
contributing factor to the development of this disorder later in
life (pg. 1832). Stated earlier that the motivation is to “assume
the sick role” (which it is thought to be a conscious action), the
authors point out that the underlying motive may actually be
unconscious (Kaplan and Sadock, 2005, pg. 1832), with two
common factors in most cases; (1) “an affinity to the medical
system” and (2) “poor, maladaptive coping skills.” Many of the
patients with factitious disorder share a similar childhood
history, to include physical and/or sexual abuse, “emotional
deprivation”, early illness with lengthy hospitalizations, poor
relationships with parents, and the tendency to activate another
psychological disorder (Hales and Yudofsky, 2003, Etiology).
Being a child from a large family could have resulted in
neglect, leading to the development of “immature coping skills”
and a preoccupation with the healthcare field (which would
explain why many factitious disorder patients enter the
healthcare field) (Kaplan and Sadock, 2005, pg. 1832). With a
potential precursor from their childhood, typically a stressful
event later in life will trigger the onset of the disorder, to
include loss of a loved one, divorce, or loss of a job (Kaplan
and Sadock, 2005, pg. 1833). Their “dependency and
narcissistic needs are fulfilled” by family, friends, and medical
staff. It is said that physical manipulation, in response to the
“extreme anxiety” and stress, are a way of relief for the patient
(Hales and Yudofsky, 2003, Etiology). Positive reinforcement
during childhood illness may also be a reason why patients
“assume the sick role” in order to find “emotional relief”
through the attention they get from loved ones (Kaplan and
Sadock, 2005, pg. 1833). With a short list of possible
childhood factors contributing to factitious disorder, there is
“no genetic or familial inheritance pattern” to date (Kaplan and
Sadock, 2005, pg. 1832).
Once a physician has a better understanding of a patient’s
medical history (such as seeing an extensive list of previous
medical procedures or surgical scars) and the conclusion that all
or most of the diagnostic tests fail to confirm a positive
diagnosis, diagnosing by exclusion seems to be a good
approach. Mental health professionals have been able to
educate physicians and other medical staff in regard to the
typical behavior of a factitious disorder patient. Some red-flag
signs to observe, especially in the emergency room setting,
include: “dramatic presentation” of symptoms that do not point
to or pinpoint a condition exactly (as in a textbook case),
symptoms and signs only present when the patient is aware that
he/she is being observed, pseudologia fantastica, disruptive
behavior towards medical staff, good understanding of medical
terminology and hospital routine, covert use of surgical tools,
supplies and substances, extensive medical procedures/scars,
peregrination (frequent traveling or moving), few visitors when
patient is finally hospitalized, an acute onset of symptoms or
“complications”, and new symptoms/signs once the initial ones
were proven negative are a common theme (DSM-IV-TR, 2000,
pg. 516). The types of symptoms feigned are generally limited
only by the patient’s creativity and medical knowledge (Kaplan
and Sadock, 2005, pg. 1833).
Diagnosis by exclusion is not as simple as it may appear. With
no set diagnostic testing, “accurate diagnosis is difficult” which
leaves the physicians puzzled and forced to eliminate all
possible etiologies (Pasic, Combs, and Romm, 2009, pg. 63).
They must continue to treat the intentionally produced medical
condition, providing “adequate care” in response to the
“physician’s ethical duty” (pg. 65). Pasic, Combs, and Romm
(2009) later go on to conclude that despite the frustration and
anger aroused in the medical staff because of erroneous and
careless attention-getting tactics, the ethical issue is addressed
again, “An individual suspected of factitious disorder has the
same rights as any patient, i.e., the right to reasonable care,
respect, privacy, safety, and confidentiality” (pg. 65). This
“ethical duty” can prove to be harmful because treating the
patient can further damage the psychological disorder by falsely
providing a positive reinforcement of their behavior. All cases
that involve a potential diagnosis of factitious disorder should
include a legal committee (Kaplan and Sadock, 2005), because
covert tactics may be required once the patient is suspected of
feigning and he/she has denied allegations. Diagnosis may not
be confirmed on many patients due to the nature of the patient
to flee when confronted. Once confronted, they may check out
against medical advice and flee to the next hospital, where new
physicians spend valuable time and money to care for the
patient before they too discover their past. It is against
confidentiality agreements between hospital and patient for the
previous hospital staff to call and warn other hospital staff
members of a potential case, therefore, diagnosis is more often
suspected than it is actually confirmed (Hales and Yudofsky,
2003).
After the tedious process of diagnosing a patient with factitious
disorder, the even more difficult process of treatment and
prognosis must be determined. In order to properly treat a
patient with factitious disorder, the “diagnosis must be
confirmed” and the physical symptoms need to be cared for
(Hales and Yudofsky, 2003). The easiest facet in treating a
factitious disorder patient is caring for the physical symptoms,
but the underlying psychological problem is the difficult part of
treating this disorder. After the diagnosis is made, any
underlying psychological problem needs to be either determined
or ruled out, such as depression or an anxiety disorder. Kaplan
and Sadock (2005) mention that treating a psychological
disorder may provide the patient with a better prognosis,
resulting in a decrease or absence of the symptoms of factitious
disorder.
There is no cure for factitious disorder, but it is thought that
management and treatment of this particular disorder may
reduce “self-harm” or “self-created disease” (Pasic, Combs, and
Romm, 2009, pg. 65), and “reduce risk of morbidity and
mortality” (Kaplan and Sadock, 2005, pg. 1841) by addressing
the psychological and emotional problems. Due to the “wide
spectrum” of physical and psychological symptoms involved, it
is important to keep this in mind when determining treatment;
each patient’s treatment plan and prognosis more than likely
will be individualized according to the current medical
complications, childhood history, and underlying psychological
problems (Kaplan and Sadock, 2005). Some common
psychological disorders that are associated with factitious
disorder include: mood disorders, anxiety, substance abuse, and
personality disorders. Each of the above mentioned have their
own unique criteria and treatment plans, all of which can be
found in the DSM-IV-TR (2000).
Some psychological problems are easier to manage than others,
so those which are associated with factitious disorder patients
will help determine the prognosis of that patient. Some
personality disorders prove to be more difficult to treat,
whereas mood, anxiety, and substance abuse prove to be easier
(Kaplan and Sadock, 2005, pg. 1840), but it is noted that many
patients will “experience remission at approximately 40 years of
age.”
A variation of this disorder is factitious disorder by proxy
(more commonly known as Munchausen Syndrome by Proxy).
This is defined by Frye (2009) as “a psychological diagnosis
applied to mothers (and other care givers) who intentionally
induce illness or injury in a child to get attention from
physicians and medical personnel.” (pg. 14). The intentionally
induced, fabricated, or exaggerated problems are not limited to
physical symptoms or illness, but rather include psychological
symptoms as well, such as learning disabilities, which require
school districts to spend countless amounts of tax payer dollars
on unnecessary testing (Frye, 2009). “Perpetrator”, referring to
any caregiver, such as a babysitter, grandparent, or stepparent,
is more commonly seen with a mother and small child, and the
perpetrator is indirectly gaining attention or sympathy through
the child (Frye, 2009, pg. 15). Factitious disorder by proxy is
classified in the DSM-IV-TR (2000) as ‘Factitious Disorder Not
Otherwise Specified’ but it is suggested for further research
(pg. 517).
According to Frye (2009), the caregiver appears to be very
interested in the well-being of the child, showing “normal”
“good” characteristics, often welcoming invasive medical
procedures (pg. 15). When it appears no one is watching, the
caregiver is often inattentive to the sick child or out of the
room, comforting other parents who have sick children in the
hospital (Frye, 2009).
With a deceptive nature, similar to factitious disorder, the
prevalence is difficult to calculate, according to Kaplan and
Sadock (2005), but once it is correctly diagnosed, hospital staff
is required by law to report it to CPS (child protective services)
because factitious disorder by proxy is treated as a form of child
abuse. The treatment of the perpetrator differs from a typical
factitious disorder patient because the victim must be cared for
and separated from the mother, while the mother needs to
receive her treatment for the underlying psychological
disorder(s) she may have. It is extremely important to remove
the child from the situation and get the caregiver help because,
according to statistics, there is a high rate of mortality and
morbidity among the victims (Kaplan and Sadock, 2005). There
are other cases of by proxy where the perpetrator (caregiver)
has a victim other than a child, such as the elderly or a spouse
(Kaplan and Sadock, 2005), but little information regarding
diagnosis, treatment, and prognosis is available at this time.
Factitious disorder and factitious disorder by proxy are
complicated, puzzling psychological disorders deep within, but
have physical symptoms and signs masking the true problem.
There is good information available, but still there are many
areas left with large question marks. The diagnosis of factitious
disorder is made difficult because patients are deceptive in
nature and ethical issues linger over the physician’s head when
confronted with how to approach the patient. Treatment is even
more difficult, because often the patient disappears before
treatment can be given, and if treatment is available, there may
be a comorbidity of psychological disorders, making it difficult
to treat them all and put factitious disorder into remission.
Although a number of factitious disorder cases are speculated,
few cases are confirmed and even fewer are treated, resulting in
limited treatment information available for mental health
clinicians and an extremely low percentage of patients who
overcome this chronic disorder. More research would be
beneficial in order to track this disorder and develop a treatment
plan. While treating these patients may be extremely
frustrating, it is necessary to treat the obvious physical
symptoms so that further complications do not occur, but by
treating the patient or trying to help them by referring to a
mental health clinician our society can gain better insight into
this deceptive disorder, and hopefully end the patient’s cycle of
deception and destruction and develop better guidelines for
diagnosis, prognosis, and treatment.
References
American Psychiatric Association (Ed.). (2000). Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition, Text
Revision (DSM-IV-TR). Arlington: American Psychiatric
Association, Inc.
Barlow, D.H., Ph.D., & Durand, V.M., Ph.D. (2005). Abnormal
Psychology: An Integrative Approach. Belmont: Wadsworth.
Feldman, M.D., M.D. (December 2006). Recovery From
Munchausen Syndrome [Letter to the editor]. Southern Medical
Journal, 99 (12), 1398-1399.
Frye, E.M., Ed.D. (Spring 2009). Factitious Disorder by Proxy
in Education. The Dialog: Journal of the Texas Educational
Diagnosticians’ Association, 38(1), 14-23.
Gabbard, G.O., M.D. (Ed.). (2007). Gabbard’s Treatments of
Psychiatric Disorders, Fourth Edition. Arlington: American
Psychiatric Publishing, Inc.
Gruber, M., Beavers, F., & Amodeo, D.J., M.D. (May 1987).
Trying to Care for the Great Pretender. Nursing, 87, 76-80.
Kokturk, N., M.D., Ekim, N., Prof., Aslan, S., M.D., Kanhay,
A., M.D., & Acar, A.T., M.D. (February 2006). A Rare Cause of
Hemoptysis: Factitious Disorder. Southern Medical Journal,
99(2), 186-187.
Kozlowska, K., Foley, S., & Crittenden, P. (2006). Factitious
Illness by Proxy: Understanding Underlying Psychological
Processess and Motivations. Australian and New Zealand
Journal of Family Therapy, 27(2), 92-104.
McDermott, B.E., Ph.D., Leaman, M.H., M.D., Feldman, M.P.,
M.D., & Scott, C.L., M.D. (2003). R.E. Hale, M.D., M.B.A. &
S. Yudofsky, M.D. (Eds.). The American Psychiatric Publishing
Textbook of Clinical Psychiatry: Ch. 14. Factitious Disorder
and Malingering. Arlington: American Psychiatric Publishing,
Inc.
Moore, K., (November 1995). Social Work’s Role with Patients
with Munchausen Syndrome. Social Work, 40(6), 823-825.
Pasic, J., M.D., Ph.D., Combs, H., M.D. & Romm, S., M.D.
(January 2009). Factitious Disorder in the Emergency
Department. Primary Psychiatry, 16(1), 61-66.
Sadock, B.J., M.D. & Sadock, V.A., M.D. (Eds.) (2005). Kaplan
and Sadock’s Comprehensive Textbook of Psychiatry, Eight
Edition: Vol. II, Ch. 24. Psychological Factors Affecting
Medical Conditions. New York: Lippincott Williams & Wilkins.
Wang, D., M.D., Nadiga, D.N., M.D., & Jenson, J.J., M.D.
(2005). B.J. Sadock, M.D. & V.A. Sadock, M.D. (Eds.) (2005).
Kaplan and Sadock’s Comprehensive Textbook of Psychiatry,
Eight Edition: Vol. I, Ch. 16. Factitious Disorders. New York:
Lippincott Williams & Wilkins.
JOURNAL ARTICLES:
For option 1 you are to use at least 2 journal articles. Journal
articles should be used after you have gotten all your basic
information for your paper. They are used to lay out a thesis or
some major topic that you are presenting in your paper. To
find these , when you read your textbook, watch for some of
their citations. If they seem to hit on some topic that you are
interested in exploring as a thesis topic, go to the book’s
reference page and look at the reference. By looking at the
title of the work, you can decide if that is the topic you are
wanting to explore in depth. If so, write down the reference.
If it is s a journal article, we likely have it, and if not, it can be
retrieved through inter-library loan. When getting information
from The American Psychiatry Association textbook of
psychiatry (2008), when reading a particular chapter, you can
click on citations that appear to hit on a topic you are interested
in exploring. By clicking on this citation, it will take you to
the reference page so you can get the information needed to
retrieve this source. If it is a book, we can get it through Inter
Library Loan (ILL) or from our databases.
When reading Kaplan & Sadock’s comprehensive textbook of
psychiatry , if you find a citation that looks like you need it to
make some points about your thesis, go the reference page and
write down that reference if it seems like it will give you
information that will be helpful.
Newspaper articles are not journal articles and can only be used
for a specific reason, but not as a professional reference. Many
times newspapers or magazines refer to research, and by getting
the name of the author leading the research and where it was
published, you can go look up this journal. Always go to the
source whenever possible.
ACCESSING APA JOURNALS
If your journal article is a psychology journal, likely we have it.
Here is how you find it. (1.) write down the reference
completely. (2.) Go to the pulaskitech homepage. (3.) click on
library (4.) click on databases by subject (4.) on the next page
select ‘Psychology’. (5.) Next page click on PsycARTICLES’
(6.) at this point you need to login as you do for Campus
Connect. (7.) enter the information you collected into the
search engine and that will bring up the article for you to
download.
USING PSYCHIATRY ONLINE (journals)
Go to the pulaskitech homepapge. (1) click on library (2.) Click
on ‘Databases by subject (3.) Click on ‘Psychology’ (4.) click
on ‘PsychiatryOnline’ (5.) login (6.) under DSM you will see
the ‘Current Journal of Pyschiatry’ that you may wish to peruse
and on the right side of the page you will see “Topics’. These
will give you current journals and topics that you may wish to
use.
ACCESSING OTHER JOURNAL ARTICLES
If you find a journal that is a medical journal of various types,
it may be that we have these in our database. One must know
exactly the name , date, volume, author, etc. in order to locate
it on the database. Go to the pulasktech homepage. (1.)
Click ‘library’. (2.) click ‘Journal Locator (3.) Type in name
of journal or click on the letter that begins the title of that
journal you are interested in locating. (4.) complete your
search.

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Option 1 Paper Abnormal PsychologyName DateTitle page (5 p.docx

  • 1. Option 1 Paper Abnormal Psychology Name: Date: Title page (5 points) Reference page (10 points) Citations (20 points) Punctuation, spelling, word usage, complete sentences, Sentence construction, etc. (10 pts.) Summary of Paper; Does it give a good explanation of The disorder and its treatment. (30 points) Thesis (10 points) Paper introduced a topic that was appropriately researched in the paper. Introduction /outro (15 points) Was there an adequate Introduction to the paper, and was there a good final paragraph or discussion.
  • 2. Total points; Comments (100 maximum) PAGE 1 My Title DOCVARIABLE SH5SectionTitleRunning head: RESEARCH PROCESS 1 DOCVARIABLE SH5SectionTitle The Research Process James L. Becker (your name here) In partial Fulfillment of Abnormal Psychology Class (section #) James L. Becker, Instructor Pulaski Technical College Date
  • 3. NOTE: PUT YOUR TITLE WHERE I HAVE MY TITLE - The Research Process. ALSO PUT In the Running Head: SHORT TITLE (SHORT TITLE IN CAPS). Subsequent pages put SHORT TITLE in upper left margin (1 inch) and page number in right margin. USE NEW TIMES ROMAN 12 FONT. Save your file as Word 97-2004 so I can open it. In this brief tutorial I want to explain how to get underway with your research process. I also want your title page to be set up in a similar fashion, and the Reference page to be set up in exactly the same way. I will demonstrate how to cite some references that you will be using in your research process. Begin your research process by selecting a disorder. After selection of your disorder, go to your textbook in order to research that particular disorder. Make thorough notes from the book. Write down your source so you can use that to make your reference properly. My advice is to put quotation marks around everything that is word for word from the book along with the page number. This will help to eliminate the possibility of plagiarism. Later, when you go to write your paper, you will know exactly what you copied word for word so you can try to put it in your own words, or if you need to quote something, you will have the page number at your fingertips. At the end of this discussion I have a sample of how to reference your textbook. As you read your textbook or any other source, if you read something that you want to look into more as a thesis, look that reference up in the back of the book. If it is a journal, we may have it at the library, and if not, you can access it through the Interlibrary Loan (ILL) program. If
  • 4. you wait until the last minute, this will eliminate this option. The next step is to go to the DSM-IV-TR (2000) which we have in our library database. I will give you step by step instructions in order to do this. Step I: Go to the Pulaski Technical College website at http://www.pulaskitech.edu Step II: Click on “Library” Step III: Find “Articles & More” Click on Databases by Subject. Step IV: Click “Psychology” Step V: Click on Psychiatry Online. At the top of this page you will find DSM-IV-TR. There are other sources to explore here, but go to DSM-IV-TR first. Click copyright, citation on your right and that will give you the information for the reference page. I will reference the DSM-IV-TR (2000) on the reference page of this document. Go to your disorder and again make notes that you will need to later write your paper. After you have researched the DSM-IV-TR (2000), go back to the page where you first found the DSM-IV-TR (2000). Scroll down until you get to “Textbooks”. Notice that there are three books about Psychopharmacology. If you wish to later research medication treatment of a particular disorder, these are wonderful sources, but for now click “Textbook of Clinical Psychiatry (Hales ,Yudofsky, & Gabbard (Eds.) ,2003). Click the citation link to note how to cite this as a reference. I have listed this in the reference page so you can see how to do this. Go to the chapter with your disorder. Note that some Chapters have authors, so in your reference you would put the Chapter # and title and author of that particular chapter. I will put one in the reference so you can see how it is supposed to appear. I
  • 5. will cite Chapter 10, Mood Disorders to illustrate this. DOCVARIABLE SH5SectionTitle DOCVARIABLE SH5SectionTitle References Factitious 1 RUNNING HEAD: FACTITIOUS DISORDER A Great Deceiver: Patients with Factitious Disorder In partial fulfillment of Abnormal Psychology Class (Summer Extended Online) Instructor July 12, 2009 According to legend, Baron Karl Friedrich Hieronymus von Munchhausen enjoyed telling larger-than-life war stories pertaining to his time spent fighting for the Russian army (Kaplan and Sadock, 2005). For the purpose of history and classification, Hales and Yudofsky (Eds. 2003) make note of this particular story for two reasons; first, it is an early account of a patient with a strange psychological disorder who has a history of peregrination intertwined with fabricated stories and wounds, and second, factitious disorder was once referred to as Munchausen Syndrome, named after the Baron and his elaborate wartime stories (Hales and Yudofsky, 2003). In 1951, a British physician, Richard Asher, coined the term Munchausen Syndrome (Hales and Yudofsky, 2003). In response to this breakthrough, Dr. Asher stated:
  • 6. Here is described a common syndrome which most doctors have seen, but about which little has been written. Like the famous Baron von Munchausen, the persons affected have always traveled widely; and their stories, like those attributed to him, are both dramatic and untruthful. Accordingly, the syndrome is respectfully dedicated to the baron, and named after him (Kaplan and Sadock, 2005, pg. 1830). Baron von Munchausen played a crucial role in the interest with this particular disorder, but earlier accounts have been noted as well, using various names. Hector Gavin, a Scottish military physician, wrote an essay in 1838 (Kaplan and Sadock, 2005) distinguishing between malingering soldiers, who are attempting to avoid further combat in the Napoleonic Wars, and the soldiers who purpose is “to excite compassion or interest” or “experience an unaccountable gratification in deceiving their officers, comrades, and surgeons” (Kaplan and Sadock, 2005, pg. 1830). In 1890, Jean-Martin Charcot uses the term mania operative active when retelling the account of a young girl in search of a surgeon to attend to her ailing knee. After several attempts, she was able to find a surgeon who would amputate her leg, but the cause of her pain had no organic basis (Kaplan and Sadock, 2005). Although cases of factitious disorder can be traced back to the second century with documented cases by the Greek physician Galen (Kaplan and Sadock, 2005), its true diagnosis is further complicated by comorbid psychological disorders and intentionally produced physical symptoms. These symptoms are mixed with a deceptive representation and medical history. This results in an inaccurate estimation of the prevalence of factitious disorder, no definitive treatment, and difficulty in determining a cure. Altogether, the symptoms lead to a chronic, lifelong cycle of wandering from doctor to doctor, unnecessary medical procedures, and medical conditions unintentionally suggested by these physicians.
  • 7. According to Barlow and Durand (2005) classify factitious disorder under a broader group, somatoform disorders. The root word soma means body; therefore people with a somatoform disorder include those who have physical symptoms, but no cause of the medical condition can be determined. Somatoform disorders tend to be quite difficult to detect and treat, according to Barlow and Durand (2005), because the physicians and clinicians have three tasks to complete; first, they must rule out the physical complaint, second, mental health professionals rule out other psychological disorders in order to properly label the type of somatoform disorder they are presented with, and third, the clinician must have a thorough understanding of the patient’s culture. With all somatoform disorders similar in presentation, they are set apart by the various motives or rewards; factitious disorder falls somewhere between conversion disorder and malingering (Barlow and Durand, 2005). The DSM-IV-TR (2000), states that “factitious disorders are characterized by physical or psychological symptoms that are intentionally produced or feigned in order to assume the sick role” (pg. 513). They desire to always be the designated patient. There are three subtypes that will be discussed later. According to this definition, factitious disorder is set apart from malingering; with malingering, “the individual also produces the symptoms intentionally, but has a goal that is obviously recognizable when the environmental circumstances are known” (DMS-IV-TR, 2000, pg. 513). Some possible motivations for a malingerer could include financial gain, not returning to combat, avoiding jury duty or other legal matters, or getting out of work (Barlow and Durand, 2005). A person with factitious disorder simply wants to “assume the sick role” and the attention that accompanies it (Barlow and Durand, 2005). There are three subtypes of factitious disorder, according to the criteria in the DSM-IV-TR (2000); first, with predominantly psychological signs and symptoms, second, with predominantly
  • 8. physical signs and symptoms, and the third, with combined psychological and physical signs and symptoms (pg. 514-515). Factitious disorder with predominantly psychological signs and symptoms is simply when a patient presents with a mental disorder, such as “depression, suicide, memory loss, hallucinations or delusions, PTSD (post-traumatic stress syndrome), or a dissociative disorder” (DMS-IV-TR, 2000, pg. 514). When predominantly physical signs and symptoms are associated with the disorder, common medical conditions can include “feigning/intentionally producing, exaggerating, or fabricating infection (e.g. abscesses), aggravating an existing wound from healing, pain (e.g. abdominal), hypoglycemia, anemia (e.g. bloodletting), rashes, seizures, dizziness, blacking out, vomiting, diarrhea, fevers, or symptoms related to an autoimmune/connective tissue disease” (DSM-IV-TR, 2000, pg. 514-515). The third subtype is simple; both psychological and physical signs and symptoms are present with neither of the two dominating (DSM-IV-TR, 2000). Defining factitious disorder is an easy task, but the difficulty begins when diagnosing a patient, determining the treatment, and providing history of the disorder. Before being able to address appropriate diagnosis and treatments, it is best for people to have sufficient knowledge of the history of this deceptive psychological disorder. Because of the deceptive nature of this disorder, accurate estimates of epidemiology and prevalence are difficult to calculate (Kaplan and Sadock, 2005). Factitious disorder patients have a tendency to leave the hospital once their medical problems are determined to be fabricated or there is supporting evidence that the symptoms were intentionally produced, leaving the patient feeling embarrassed or humiliated (Pasic, Combs, and Romm, 2009). Not only does the patient fleeing the scene lead to no help and a greater chance of no cure for their problem, it causes another issue for researchers who are trying to determine the
  • 9. prevalence. It is thought that with their repeated roaming from one physician or medical facility to another as a common characteristic, some patients may be counted more than once in a location which may lead to an overestimation. Factitious disorder may be underestimated because the patients are fleeing when found out rather than seeking the help they need (Hales and Yudofsky, 2003, Epidemiology). Of the known cases, the prevalence differs with each hospital, various studies, and depending on the specialty of the physician (Hales and Yudofsky, 2003). As mentioned by Pasic, Combs, and Romm (2009), the majority of patients tend to be women between the ages of 20-40 and are “often employed in the medical field as nurses, medical technicians, or other health- related jobs” (pg. 63). Several different studies have been performed in order to calculate a potential prevalence rate; they can be found in Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, Eight Edition, Vol. I, on page 1831-1832 or Hales and Yudofsky’s Textbook of Psychiatry. However, according to the DSM-IV-TR (2000), “the best data indicate that, within large general hospitals, Factitious Disorder is diagnosed for about 1 % of the patients on whom mental health professionals consult” and is “greater in highly specialized treatment settings.” (pg. 516). Not only is this a rare disorder, it can be very puzzling to researchers and clinicians. Now that the complicated task of determining prevalence has been addressed, one can focus on the information that is available to clinicians and physicians. Before discussing the complicated issues of diagnosing a patient with factitious disorder, understanding potential causes may be helpful in narrowing the affected population. Of the documented cases, a common factor is present in a majority of the patients. After much research, Kaplan and Sadock (2005) note that “the
  • 10. etiology of factitious disorder is not known” but they can associate a list of possible childhood events that may be a contributing factor to the development of this disorder later in life (pg. 1832). Stated earlier that the motivation is to “assume the sick role” (which it is thought to be a conscious action), the authors point out that the underlying motive may actually be unconscious (Kaplan and Sadock, 2005, pg. 1832), with two common factors in most cases; (1) “an affinity to the medical system” and (2) “poor, maladaptive coping skills.” Many of the patients with factitious disorder share a similar childhood history, to include physical and/or sexual abuse, “emotional deprivation”, early illness with lengthy hospitalizations, poor relationships with parents, and the tendency to activate another psychological disorder (Hales and Yudofsky, 2003, Etiology). Being a child from a large family could have resulted in neglect, leading to the development of “immature coping skills” and a preoccupation with the healthcare field (which would explain why many factitious disorder patients enter the healthcare field) (Kaplan and Sadock, 2005, pg. 1832). With a potential precursor from their childhood, typically a stressful event later in life will trigger the onset of the disorder, to include loss of a loved one, divorce, or loss of a job (Kaplan and Sadock, 2005, pg. 1833). Their “dependency and narcissistic needs are fulfilled” by family, friends, and medical staff. It is said that physical manipulation, in response to the “extreme anxiety” and stress, are a way of relief for the patient (Hales and Yudofsky, 2003, Etiology). Positive reinforcement during childhood illness may also be a reason why patients “assume the sick role” in order to find “emotional relief” through the attention they get from loved ones (Kaplan and Sadock, 2005, pg. 1833). With a short list of possible childhood factors contributing to factitious disorder, there is “no genetic or familial inheritance pattern” to date (Kaplan and Sadock, 2005, pg. 1832).
  • 11. Once a physician has a better understanding of a patient’s medical history (such as seeing an extensive list of previous medical procedures or surgical scars) and the conclusion that all or most of the diagnostic tests fail to confirm a positive diagnosis, diagnosing by exclusion seems to be a good approach. Mental health professionals have been able to educate physicians and other medical staff in regard to the typical behavior of a factitious disorder patient. Some red-flag signs to observe, especially in the emergency room setting, include: “dramatic presentation” of symptoms that do not point to or pinpoint a condition exactly (as in a textbook case), symptoms and signs only present when the patient is aware that he/she is being observed, pseudologia fantastica, disruptive behavior towards medical staff, good understanding of medical terminology and hospital routine, covert use of surgical tools, supplies and substances, extensive medical procedures/scars, peregrination (frequent traveling or moving), few visitors when patient is finally hospitalized, an acute onset of symptoms or “complications”, and new symptoms/signs once the initial ones were proven negative are a common theme (DSM-IV-TR, 2000, pg. 516). The types of symptoms feigned are generally limited only by the patient’s creativity and medical knowledge (Kaplan and Sadock, 2005, pg. 1833). Diagnosis by exclusion is not as simple as it may appear. With no set diagnostic testing, “accurate diagnosis is difficult” which leaves the physicians puzzled and forced to eliminate all possible etiologies (Pasic, Combs, and Romm, 2009, pg. 63). They must continue to treat the intentionally produced medical condition, providing “adequate care” in response to the “physician’s ethical duty” (pg. 65). Pasic, Combs, and Romm (2009) later go on to conclude that despite the frustration and anger aroused in the medical staff because of erroneous and careless attention-getting tactics, the ethical issue is addressed again, “An individual suspected of factitious disorder has the same rights as any patient, i.e., the right to reasonable care,
  • 12. respect, privacy, safety, and confidentiality” (pg. 65). This “ethical duty” can prove to be harmful because treating the patient can further damage the psychological disorder by falsely providing a positive reinforcement of their behavior. All cases that involve a potential diagnosis of factitious disorder should include a legal committee (Kaplan and Sadock, 2005), because covert tactics may be required once the patient is suspected of feigning and he/she has denied allegations. Diagnosis may not be confirmed on many patients due to the nature of the patient to flee when confronted. Once confronted, they may check out against medical advice and flee to the next hospital, where new physicians spend valuable time and money to care for the patient before they too discover their past. It is against confidentiality agreements between hospital and patient for the previous hospital staff to call and warn other hospital staff members of a potential case, therefore, diagnosis is more often suspected than it is actually confirmed (Hales and Yudofsky, 2003). After the tedious process of diagnosing a patient with factitious disorder, the even more difficult process of treatment and prognosis must be determined. In order to properly treat a patient with factitious disorder, the “diagnosis must be confirmed” and the physical symptoms need to be cared for (Hales and Yudofsky, 2003). The easiest facet in treating a factitious disorder patient is caring for the physical symptoms, but the underlying psychological problem is the difficult part of treating this disorder. After the diagnosis is made, any underlying psychological problem needs to be either determined or ruled out, such as depression or an anxiety disorder. Kaplan and Sadock (2005) mention that treating a psychological disorder may provide the patient with a better prognosis, resulting in a decrease or absence of the symptoms of factitious disorder. There is no cure for factitious disorder, but it is thought that
  • 13. management and treatment of this particular disorder may reduce “self-harm” or “self-created disease” (Pasic, Combs, and Romm, 2009, pg. 65), and “reduce risk of morbidity and mortality” (Kaplan and Sadock, 2005, pg. 1841) by addressing the psychological and emotional problems. Due to the “wide spectrum” of physical and psychological symptoms involved, it is important to keep this in mind when determining treatment; each patient’s treatment plan and prognosis more than likely will be individualized according to the current medical complications, childhood history, and underlying psychological problems (Kaplan and Sadock, 2005). Some common psychological disorders that are associated with factitious disorder include: mood disorders, anxiety, substance abuse, and personality disorders. Each of the above mentioned have their own unique criteria and treatment plans, all of which can be found in the DSM-IV-TR (2000). Some psychological problems are easier to manage than others, so those which are associated with factitious disorder patients will help determine the prognosis of that patient. Some personality disorders prove to be more difficult to treat, whereas mood, anxiety, and substance abuse prove to be easier (Kaplan and Sadock, 2005, pg. 1840), but it is noted that many patients will “experience remission at approximately 40 years of age.” A variation of this disorder is factitious disorder by proxy (more commonly known as Munchausen Syndrome by Proxy). This is defined by Frye (2009) as “a psychological diagnosis applied to mothers (and other care givers) who intentionally induce illness or injury in a child to get attention from physicians and medical personnel.” (pg. 14). The intentionally induced, fabricated, or exaggerated problems are not limited to physical symptoms or illness, but rather include psychological symptoms as well, such as learning disabilities, which require
  • 14. school districts to spend countless amounts of tax payer dollars on unnecessary testing (Frye, 2009). “Perpetrator”, referring to any caregiver, such as a babysitter, grandparent, or stepparent, is more commonly seen with a mother and small child, and the perpetrator is indirectly gaining attention or sympathy through the child (Frye, 2009, pg. 15). Factitious disorder by proxy is classified in the DSM-IV-TR (2000) as ‘Factitious Disorder Not Otherwise Specified’ but it is suggested for further research (pg. 517). According to Frye (2009), the caregiver appears to be very interested in the well-being of the child, showing “normal” “good” characteristics, often welcoming invasive medical procedures (pg. 15). When it appears no one is watching, the caregiver is often inattentive to the sick child or out of the room, comforting other parents who have sick children in the hospital (Frye, 2009). With a deceptive nature, similar to factitious disorder, the prevalence is difficult to calculate, according to Kaplan and Sadock (2005), but once it is correctly diagnosed, hospital staff is required by law to report it to CPS (child protective services) because factitious disorder by proxy is treated as a form of child abuse. The treatment of the perpetrator differs from a typical factitious disorder patient because the victim must be cared for and separated from the mother, while the mother needs to receive her treatment for the underlying psychological disorder(s) she may have. It is extremely important to remove the child from the situation and get the caregiver help because, according to statistics, there is a high rate of mortality and morbidity among the victims (Kaplan and Sadock, 2005). There are other cases of by proxy where the perpetrator (caregiver) has a victim other than a child, such as the elderly or a spouse (Kaplan and Sadock, 2005), but little information regarding diagnosis, treatment, and prognosis is available at this time.
  • 15. Factitious disorder and factitious disorder by proxy are complicated, puzzling psychological disorders deep within, but have physical symptoms and signs masking the true problem. There is good information available, but still there are many areas left with large question marks. The diagnosis of factitious disorder is made difficult because patients are deceptive in nature and ethical issues linger over the physician’s head when confronted with how to approach the patient. Treatment is even more difficult, because often the patient disappears before treatment can be given, and if treatment is available, there may be a comorbidity of psychological disorders, making it difficult to treat them all and put factitious disorder into remission. Although a number of factitious disorder cases are speculated, few cases are confirmed and even fewer are treated, resulting in limited treatment information available for mental health clinicians and an extremely low percentage of patients who overcome this chronic disorder. More research would be beneficial in order to track this disorder and develop a treatment plan. While treating these patients may be extremely frustrating, it is necessary to treat the obvious physical symptoms so that further complications do not occur, but by treating the patient or trying to help them by referring to a mental health clinician our society can gain better insight into this deceptive disorder, and hopefully end the patient’s cycle of deception and destruction and develop better guidelines for diagnosis, prognosis, and treatment. References American Psychiatric Association (Ed.). (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Arlington: American Psychiatric Association, Inc. Barlow, D.H., Ph.D., & Durand, V.M., Ph.D. (2005). Abnormal Psychology: An Integrative Approach. Belmont: Wadsworth.
  • 16. Feldman, M.D., M.D. (December 2006). Recovery From Munchausen Syndrome [Letter to the editor]. Southern Medical Journal, 99 (12), 1398-1399. Frye, E.M., Ed.D. (Spring 2009). Factitious Disorder by Proxy in Education. The Dialog: Journal of the Texas Educational Diagnosticians’ Association, 38(1), 14-23. Gabbard, G.O., M.D. (Ed.). (2007). Gabbard’s Treatments of Psychiatric Disorders, Fourth Edition. Arlington: American Psychiatric Publishing, Inc. Gruber, M., Beavers, F., & Amodeo, D.J., M.D. (May 1987). Trying to Care for the Great Pretender. Nursing, 87, 76-80. Kokturk, N., M.D., Ekim, N., Prof., Aslan, S., M.D., Kanhay, A., M.D., & Acar, A.T., M.D. (February 2006). A Rare Cause of Hemoptysis: Factitious Disorder. Southern Medical Journal, 99(2), 186-187. Kozlowska, K., Foley, S., & Crittenden, P. (2006). Factitious Illness by Proxy: Understanding Underlying Psychological Processess and Motivations. Australian and New Zealand Journal of Family Therapy, 27(2), 92-104. McDermott, B.E., Ph.D., Leaman, M.H., M.D., Feldman, M.P., M.D., & Scott, C.L., M.D. (2003). R.E. Hale, M.D., M.B.A. & S. Yudofsky, M.D. (Eds.). The American Psychiatric Publishing Textbook of Clinical Psychiatry: Ch. 14. Factitious Disorder and Malingering. Arlington: American Psychiatric Publishing, Inc. Moore, K., (November 1995). Social Work’s Role with Patients with Munchausen Syndrome. Social Work, 40(6), 823-825. Pasic, J., M.D., Ph.D., Combs, H., M.D. & Romm, S., M.D. (January 2009). Factitious Disorder in the Emergency
  • 17. Department. Primary Psychiatry, 16(1), 61-66. Sadock, B.J., M.D. & Sadock, V.A., M.D. (Eds.) (2005). Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, Eight Edition: Vol. II, Ch. 24. Psychological Factors Affecting Medical Conditions. New York: Lippincott Williams & Wilkins. Wang, D., M.D., Nadiga, D.N., M.D., & Jenson, J.J., M.D. (2005). B.J. Sadock, M.D. & V.A. Sadock, M.D. (Eds.) (2005). Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, Eight Edition: Vol. I, Ch. 16. Factitious Disorders. New York: Lippincott Williams & Wilkins. JOURNAL ARTICLES: For option 1 you are to use at least 2 journal articles. Journal articles should be used after you have gotten all your basic information for your paper. They are used to lay out a thesis or some major topic that you are presenting in your paper. To find these , when you read your textbook, watch for some of their citations. If they seem to hit on some topic that you are interested in exploring as a thesis topic, go to the book’s reference page and look at the reference. By looking at the title of the work, you can decide if that is the topic you are wanting to explore in depth. If so, write down the reference. If it is s a journal article, we likely have it, and if not, it can be retrieved through inter-library loan. When getting information from The American Psychiatry Association textbook of psychiatry (2008), when reading a particular chapter, you can click on citations that appear to hit on a topic you are interested in exploring. By clicking on this citation, it will take you to the reference page so you can get the information needed to retrieve this source. If it is a book, we can get it through Inter Library Loan (ILL) or from our databases.
  • 18. When reading Kaplan & Sadock’s comprehensive textbook of psychiatry , if you find a citation that looks like you need it to make some points about your thesis, go the reference page and write down that reference if it seems like it will give you information that will be helpful. Newspaper articles are not journal articles and can only be used for a specific reason, but not as a professional reference. Many times newspapers or magazines refer to research, and by getting the name of the author leading the research and where it was published, you can go look up this journal. Always go to the source whenever possible. ACCESSING APA JOURNALS If your journal article is a psychology journal, likely we have it. Here is how you find it. (1.) write down the reference completely. (2.) Go to the pulaskitech homepage. (3.) click on library (4.) click on databases by subject (4.) on the next page select ‘Psychology’. (5.) Next page click on PsycARTICLES’ (6.) at this point you need to login as you do for Campus Connect. (7.) enter the information you collected into the search engine and that will bring up the article for you to download. USING PSYCHIATRY ONLINE (journals)
  • 19. Go to the pulaskitech homepapge. (1) click on library (2.) Click on ‘Databases by subject (3.) Click on ‘Psychology’ (4.) click on ‘PsychiatryOnline’ (5.) login (6.) under DSM you will see the ‘Current Journal of Pyschiatry’ that you may wish to peruse and on the right side of the page you will see “Topics’. These will give you current journals and topics that you may wish to use. ACCESSING OTHER JOURNAL ARTICLES If you find a journal that is a medical journal of various types, it may be that we have these in our database. One must know exactly the name , date, volume, author, etc. in order to locate it on the database. Go to the pulasktech homepage. (1.) Click ‘library’. (2.) click ‘Journal Locator (3.) Type in name of journal or click on the letter that begins the title of that journal you are interested in locating. (4.) complete your search.