The facilitating group posted discussion prompts on somatization disorder, depression, and the link between social media use and depression in adolescents.
For somatization disorder, they asked how therapeutic interventions would be formulated and how success would be evaluated. For depression, they asked how views on living with depression may have changed after watching a video, what interventions and resources would be used and how treatment success would be evaluated. For social media and adolescent depression, they asked for non-pharmacological interventions and an appropriate medication choice along with important patient education.
A peer responded by discussing screening and treatment of somatization disorder including psychotherapy and medications. For depression, the peer discussed the neurobiology, diagnostic criteria, treatment options of
AssignmentWrite a Respond to two of these #1&2 case studies.docxnormanibarber20063
Assignment:
Write a Respond to two of these #1&2 case studies using one or more of the following approaches:
Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
Suggest additional health-related risks that might be considered.
Validate an idea with your own experience and additional research.
Each must have at least 2 references no more than 5 years old using APA Format
Response # 1
“The case of physician do not heal thyself”
Three questions I will ask the patient on a visit to my office and rationale thereof.
Major depressive disorder (MDD) is defined as “feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home” and it is one of the most common reasons patients present for medical care worldwide (McConnell, Carter & Patterson, 2019). Childhood traumatic experiences, including physical, sexual, and emotional abuse, neglect, and separation from caregivers, they posit significantly increase the risk of developing mental and physical illnesses later in life.
NO .1
Have you had any thoughts of death or suicide before? Are you having them now? And do you have a current plan to harm or kill yourself? What are the details of that plan?
McConnell,et .al, (2019) posit that clients with MDD often presents with feeling sad or depressed; lack of interest or pleasure in previously enjoyed activities; appetite changes (unintentional weight loss or gain); sleep difficulty (too much or little); lack of energy (fatigue); feeling of guiltiness or worthlessness; moving more slowly or pacing (others observe); difficulty with decision-making, concentration, and thinking; and/or suicidal thoughts.
Patient safety remains a central concern in every healthcare setting (Smith,2018). This patient did report several feelings of Suicide Ideation and Homicidal ideation so patients’ safety should be priority. Although the welfare of patients encompasses a broad range of concerns, the increasing prevalence of suicide in our society compels health care workers to ensure a safe healthcare environment for patients with suicidal ideation. These efforts include the elimination or, at least, the mitigation of physical setting characteristics that enable suicide attempts.
No 2.
Are you depressed? How does this problem make you feel? What makes the problem better?
According to DSM-5 (2013) diagnostic criteria, MDD requires five or more of the following symptoms during the same two-week period and represent a change from previous functioning; at least one symptom is either 1) depressed mood or 2) loss of interest or pleasure (American Psychiatric Association [APA], 2013).
According to the patient’s file, he has experienced five or more of the symptoms of MDD during the same two-week period, on more than one occasion, incl.
Student 1 JudyWhat medications are considered first-line bemilissaccm
Student 1: Judy
What medications are considered first-line best practices for treating anxiety? How long can they expect these medications to take full effect? Alternative to use?
Selective serotonin reuptake inhibitors (SSRIs) are recommended as a first-line treatment for anxiety disorders (Bandelow et al., 2017). They increase serotonin levels by blocking the serotonin transporter (SERT) which helps to reduce anxiety (Stahl & Muntner, 2021). These drugs can be used long-term due to better tolerability, less sedation, and less chance of abuse or withdrawal (Bandelow et al., 2017). A study that was conducted by Jakubovski et al (2018), also reported that serotonin-norepinephrine reuptake inhibitors (SNRIs) are also the first-line
pharmacological
treatment for anxiety disorders, but higher doses of these medications are not needed to relieve anxiety. Therefore, the pharmacotherapeutic treatment is somewhat a matter of professional expertise and what the provider is comfortable with prescribing.
What therapy would be indicated for someone with anxiety?
Cognitive behavior therapy (CBT) can be indicated for someone with anxiety. It can be used to examine negative thoughts that contribute to anxiety symptoms and replace those thoughts with more positive realistic thoughts. This type of therapy approach is to help clients identify irrational thoughts and help them analyze their negative beliefs. Furthermore, the use of an SSRI with CBT can reduce the activity in the amygdala and insula which is responsible for pain and emotional perception, and addictive behaviors (Gorka et al., 2019).
What do you need to assess before prescribing a benzodiazepine? What special considerations should be given and discussed with the patient?
Benzodiazepines may be used in the management of diseases such as insomnia or anxiety. However, the use of benzodiazepines can result in respiratory depression due to its effects on the central nervous system hence patients should be educated on its use and contraindications. Benzodiazepines are recommended for short-term pharmacotherapeutic treatment use due to the significant risk of dependence. Long-term benzodiazepines should be avoided if possible due to the risk of dependence, possible abuse, and cognitive decline (Stahl, 2017). Moreover, patients should be tapered off long-term use if they can tolerate the discontinuation without severe withdrawal. According to Takaesu et al (2019), patients taking benzodiazepines are at increased risk of cognitive function decline, falls, as well as dependence, and tolerance. That being said, benzodiazepines should not be considered first-line due to their high potential for abuse.
Last Name: I-N
Body Dysmorphic Disorder (F45.22)
How would you define the disorder?
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) (2013), defines body dysmorphic disorder (BDD) as a preoccupation with one or more flaws in physical appearance that others do not see that ...
Discussion QuestionWhat you do think will be the market impact.docxelinoraudley582231
Discussion Question
What you do think will be the market impact(s) of the proposed increase in the federal minimum wage to $10 per hour?
a) Will the proposed increase help workers? And if so which part(s) of the labor market will be helped.
b) Which part(s) of the labor market will hurt by the proposed increase? How will they be hurt?
c) What will happen to the prices of goods and services produced with minimum wage labor?
3) What is your conclusion? Is this proposal a good idea or not? Explain why.
POST MUST BE BETWEEN 200-250 WORDS, APA FORMAT
Journal of Counseling & Development ■ Winter 2005 ■ Volume 83116
Trends
One of the most common disorders facing people today is
depression. By some estimates, roughly 10% to 25% of the
population experiences some form of depression. Accord-
ing to Murray and Lopez (1997), depression is the number
one cause of disability worldwide. It is clearly the most com-
mon disorder experienced by people who see mental health
practitioners (Gilroy, Carroll, & Murra, 2002). Also, it may be
the most common disorder of mental health workers them-
selves (Mahoney, 1997; Pope & Tabachnik, 1994), with re-
search suggesting that from one third to more than 60% of
mental health professionals had reported a significant epi-
sode of depression within the previous year. Depressing? Yes,
but there is hope and good news. Depression, by and large, is
a problem readily amenable to treatment, and there are many
successful approaches, many of which have empirical evi-
dence to support their efficacy. The bad news, however, is that
depression has been increasing in epidemic proportions. Data
reflect that depression is 10 times as prevalent now as it was in
1960! Seligman (2002) provided a provocative paradox on
depression. He stated that while every objective indicator of
well-being in the U.S. has been increasing, every indicator of
subjective well-being is decreasing.
Clearly, the importance of the current knowledge base on
depression is obvious. Counselors, from pre-K to adult men-
tal health workers, need to be well-versed on the current
state of treatment for depression. For counselors, it is quite
likely that for many of their clients, whether they present
with problems of mood disturbance or not, depression may
be involved. For professionals, who are at high risk for mood
disorders by the very nature of their work, the importance of
treatment and prevention in self-care is critical. Thus, this
topic has considerable value because it is quite likely that
counselors will work with clients with depression, and it is
quite likely, given the empirical evidence, that counselors
are experiencing or will be experiencing some form of de-
pression/mood disturbance themselves.
The article “Treatment and Prevention of Depression”
(Hollon, Thase, & Markowitz, 2002) reviews the current state
of research on various treatment modalities, comparing the
effectiveness of the more widely used approaches—psycho-
dynamic therapy.
Reply to Comment· Collapse SubdiscussionEmilia EgwimEmil.docxlillie234567
Reply to Comment
·
Collapse SubdiscussionEmilia Egwim
Emilia Egwim
8:33amDec 21 at 8:33am
Manage Discussion Entry
Discussion for Comprehensive Focused Soap Psychiatric Evaluation
Hello Lovelyne
Great presentation; I really enjoy reading your presentation about your patient Joey which is very informative. Autism Spectrum disorder is a neurodevelopmental disorder that is associated with tenacious predicaments in social communication and interaction in addition with limited, continual model of behaviors. According to study by Fitzpatrick et al; indicated that aggression behavior are noted to be increased in individual with ASD than when compared with other neurodevelopmental impairments (2016). This aggressive behavioral issues has been indicated by studies to relate with obstructive consequences for children diagnosed with ASD and their care providers resulting in reduced quality of life, heightened stress levels and decreased accessibility of educational and social adaptation/acceptance. Studies indicated that establishing effective therapeutic and pharmacological intervention approach for treatment as well as preventing aggressive behavior is imperative for reaching to better outcomes for individual with ASD. The patient in this case presentation had history of ASD and endorses aggression and self-injuries behaviors which have been indicated by various studies to associated with ASD and other manifestation including hyperactive, impulsive, inattentive behavior, unusual mood or emotional reaction.
To answer your question “
Is Risperidone FDA approved for patients with Autism”
Based on various studies, Risperidone and aripiprazole are approved by FDA and recommended for treatment of schizophrenia and bipolar for adult and adolescent including children with Autism Spectrum disorder around age 5 to 16 years. The Risperidone an antipsychotic medication was recommended to treat the aggression, irritability and mood swings associated with ASD. According to study; Risperidone has been effecting in treating symptoms of aggression and irritability between the age of 5 and 6 years distinctly that is associated with ASD, however, there’s no FDA approved medication for treatment of core sign and symptoms of ASD (Alayouf et al, 2021). There have been several controversy surrounding the use of Risperidone in which several clinician trials conducted reported that the medication was effective for the agitation, aggression and irritability often observed in autism patient, but was less effective in treating the core symptoms of Autism and other argument including the undesirable side effects that are associated with the medication and most significant of which is weight gain from an increased appetite. Other several medication as well as off-label prescription has been indicated to be effective such as treatment with SSRIs, CNS stimulants, NMDA-receptor antagonists, and including other agents (LeClerc & Easley, 2015). I completely agree with th.
AssignmentWrite a Respond to two of these #1&2 case studies.docxnormanibarber20063
Assignment:
Write a Respond to two of these #1&2 case studies using one or more of the following approaches:
Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
Suggest additional health-related risks that might be considered.
Validate an idea with your own experience and additional research.
Each must have at least 2 references no more than 5 years old using APA Format
Response # 1
“The case of physician do not heal thyself”
Three questions I will ask the patient on a visit to my office and rationale thereof.
Major depressive disorder (MDD) is defined as “feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home” and it is one of the most common reasons patients present for medical care worldwide (McConnell, Carter & Patterson, 2019). Childhood traumatic experiences, including physical, sexual, and emotional abuse, neglect, and separation from caregivers, they posit significantly increase the risk of developing mental and physical illnesses later in life.
NO .1
Have you had any thoughts of death or suicide before? Are you having them now? And do you have a current plan to harm or kill yourself? What are the details of that plan?
McConnell,et .al, (2019) posit that clients with MDD often presents with feeling sad or depressed; lack of interest or pleasure in previously enjoyed activities; appetite changes (unintentional weight loss or gain); sleep difficulty (too much or little); lack of energy (fatigue); feeling of guiltiness or worthlessness; moving more slowly or pacing (others observe); difficulty with decision-making, concentration, and thinking; and/or suicidal thoughts.
Patient safety remains a central concern in every healthcare setting (Smith,2018). This patient did report several feelings of Suicide Ideation and Homicidal ideation so patients’ safety should be priority. Although the welfare of patients encompasses a broad range of concerns, the increasing prevalence of suicide in our society compels health care workers to ensure a safe healthcare environment for patients with suicidal ideation. These efforts include the elimination or, at least, the mitigation of physical setting characteristics that enable suicide attempts.
No 2.
Are you depressed? How does this problem make you feel? What makes the problem better?
According to DSM-5 (2013) diagnostic criteria, MDD requires five or more of the following symptoms during the same two-week period and represent a change from previous functioning; at least one symptom is either 1) depressed mood or 2) loss of interest or pleasure (American Psychiatric Association [APA], 2013).
According to the patient’s file, he has experienced five or more of the symptoms of MDD during the same two-week period, on more than one occasion, incl.
Student 1 JudyWhat medications are considered first-line bemilissaccm
Student 1: Judy
What medications are considered first-line best practices for treating anxiety? How long can they expect these medications to take full effect? Alternative to use?
Selective serotonin reuptake inhibitors (SSRIs) are recommended as a first-line treatment for anxiety disorders (Bandelow et al., 2017). They increase serotonin levels by blocking the serotonin transporter (SERT) which helps to reduce anxiety (Stahl & Muntner, 2021). These drugs can be used long-term due to better tolerability, less sedation, and less chance of abuse or withdrawal (Bandelow et al., 2017). A study that was conducted by Jakubovski et al (2018), also reported that serotonin-norepinephrine reuptake inhibitors (SNRIs) are also the first-line
pharmacological
treatment for anxiety disorders, but higher doses of these medications are not needed to relieve anxiety. Therefore, the pharmacotherapeutic treatment is somewhat a matter of professional expertise and what the provider is comfortable with prescribing.
What therapy would be indicated for someone with anxiety?
Cognitive behavior therapy (CBT) can be indicated for someone with anxiety. It can be used to examine negative thoughts that contribute to anxiety symptoms and replace those thoughts with more positive realistic thoughts. This type of therapy approach is to help clients identify irrational thoughts and help them analyze their negative beliefs. Furthermore, the use of an SSRI with CBT can reduce the activity in the amygdala and insula which is responsible for pain and emotional perception, and addictive behaviors (Gorka et al., 2019).
What do you need to assess before prescribing a benzodiazepine? What special considerations should be given and discussed with the patient?
Benzodiazepines may be used in the management of diseases such as insomnia or anxiety. However, the use of benzodiazepines can result in respiratory depression due to its effects on the central nervous system hence patients should be educated on its use and contraindications. Benzodiazepines are recommended for short-term pharmacotherapeutic treatment use due to the significant risk of dependence. Long-term benzodiazepines should be avoided if possible due to the risk of dependence, possible abuse, and cognitive decline (Stahl, 2017). Moreover, patients should be tapered off long-term use if they can tolerate the discontinuation without severe withdrawal. According to Takaesu et al (2019), patients taking benzodiazepines are at increased risk of cognitive function decline, falls, as well as dependence, and tolerance. That being said, benzodiazepines should not be considered first-line due to their high potential for abuse.
Last Name: I-N
Body Dysmorphic Disorder (F45.22)
How would you define the disorder?
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) (2013), defines body dysmorphic disorder (BDD) as a preoccupation with one or more flaws in physical appearance that others do not see that ...
Discussion QuestionWhat you do think will be the market impact.docxelinoraudley582231
Discussion Question
What you do think will be the market impact(s) of the proposed increase in the federal minimum wage to $10 per hour?
a) Will the proposed increase help workers? And if so which part(s) of the labor market will be helped.
b) Which part(s) of the labor market will hurt by the proposed increase? How will they be hurt?
c) What will happen to the prices of goods and services produced with minimum wage labor?
3) What is your conclusion? Is this proposal a good idea or not? Explain why.
POST MUST BE BETWEEN 200-250 WORDS, APA FORMAT
Journal of Counseling & Development ■ Winter 2005 ■ Volume 83116
Trends
One of the most common disorders facing people today is
depression. By some estimates, roughly 10% to 25% of the
population experiences some form of depression. Accord-
ing to Murray and Lopez (1997), depression is the number
one cause of disability worldwide. It is clearly the most com-
mon disorder experienced by people who see mental health
practitioners (Gilroy, Carroll, & Murra, 2002). Also, it may be
the most common disorder of mental health workers them-
selves (Mahoney, 1997; Pope & Tabachnik, 1994), with re-
search suggesting that from one third to more than 60% of
mental health professionals had reported a significant epi-
sode of depression within the previous year. Depressing? Yes,
but there is hope and good news. Depression, by and large, is
a problem readily amenable to treatment, and there are many
successful approaches, many of which have empirical evi-
dence to support their efficacy. The bad news, however, is that
depression has been increasing in epidemic proportions. Data
reflect that depression is 10 times as prevalent now as it was in
1960! Seligman (2002) provided a provocative paradox on
depression. He stated that while every objective indicator of
well-being in the U.S. has been increasing, every indicator of
subjective well-being is decreasing.
Clearly, the importance of the current knowledge base on
depression is obvious. Counselors, from pre-K to adult men-
tal health workers, need to be well-versed on the current
state of treatment for depression. For counselors, it is quite
likely that for many of their clients, whether they present
with problems of mood disturbance or not, depression may
be involved. For professionals, who are at high risk for mood
disorders by the very nature of their work, the importance of
treatment and prevention in self-care is critical. Thus, this
topic has considerable value because it is quite likely that
counselors will work with clients with depression, and it is
quite likely, given the empirical evidence, that counselors
are experiencing or will be experiencing some form of de-
pression/mood disturbance themselves.
The article “Treatment and Prevention of Depression”
(Hollon, Thase, & Markowitz, 2002) reviews the current state
of research on various treatment modalities, comparing the
effectiveness of the more widely used approaches—psycho-
dynamic therapy.
Reply to Comment· Collapse SubdiscussionEmilia EgwimEmil.docxlillie234567
Reply to Comment
·
Collapse SubdiscussionEmilia Egwim
Emilia Egwim
8:33amDec 21 at 8:33am
Manage Discussion Entry
Discussion for Comprehensive Focused Soap Psychiatric Evaluation
Hello Lovelyne
Great presentation; I really enjoy reading your presentation about your patient Joey which is very informative. Autism Spectrum disorder is a neurodevelopmental disorder that is associated with tenacious predicaments in social communication and interaction in addition with limited, continual model of behaviors. According to study by Fitzpatrick et al; indicated that aggression behavior are noted to be increased in individual with ASD than when compared with other neurodevelopmental impairments (2016). This aggressive behavioral issues has been indicated by studies to relate with obstructive consequences for children diagnosed with ASD and their care providers resulting in reduced quality of life, heightened stress levels and decreased accessibility of educational and social adaptation/acceptance. Studies indicated that establishing effective therapeutic and pharmacological intervention approach for treatment as well as preventing aggressive behavior is imperative for reaching to better outcomes for individual with ASD. The patient in this case presentation had history of ASD and endorses aggression and self-injuries behaviors which have been indicated by various studies to associated with ASD and other manifestation including hyperactive, impulsive, inattentive behavior, unusual mood or emotional reaction.
To answer your question “
Is Risperidone FDA approved for patients with Autism”
Based on various studies, Risperidone and aripiprazole are approved by FDA and recommended for treatment of schizophrenia and bipolar for adult and adolescent including children with Autism Spectrum disorder around age 5 to 16 years. The Risperidone an antipsychotic medication was recommended to treat the aggression, irritability and mood swings associated with ASD. According to study; Risperidone has been effecting in treating symptoms of aggression and irritability between the age of 5 and 6 years distinctly that is associated with ASD, however, there’s no FDA approved medication for treatment of core sign and symptoms of ASD (Alayouf et al, 2021). There have been several controversy surrounding the use of Risperidone in which several clinician trials conducted reported that the medication was effective for the agitation, aggression and irritability often observed in autism patient, but was less effective in treating the core symptoms of Autism and other argument including the undesirable side effects that are associated with the medication and most significant of which is weight gain from an increased appetite. Other several medication as well as off-label prescription has been indicated to be effective such as treatment with SSRIs, CNS stimulants, NMDA-receptor antagonists, and including other agents (LeClerc & Easley, 2015). I completely agree with th.
1
3
Test Development Proposal: Step One
Jane Doe
The University of Arizona Global Campus
RES7402: Advanced Tests & Measurements (QAH114DS)
Dr. John Doe
April 5, 2021
Test Development Proposal: Step One
Bushnell et al. 2019, describes depression disorder as disorder that affects an individual's mood, usually making them has an unrelenting feeling of sadness and interest loss (p.908). The condition leads to a variety of physical and emotional problems. The patients, therefore, experience trouble doing day-to-day activities. Older adults and women are at a high risk of this condition. Understanding the complexities 0f depression, diagnosis, and treatment has never been more critical, whether developing a better understanding of depression to an individual’s personal life, a team, and an organization that directly impacts communities. A better understanding of depression is also fundamental in offering innovative leadership ideas on handling this condition. This is especially very important because data illustrates that there are a lot of deaths that are attributed to depression.
In this construct, various characteristics can be assessed, but I will be assessing the symptoms of this condition in this case. Various characteristics are present to people suffering from this condition. Some of the characteristics include feelings of sadness and interest loss, suicidal tendencies, disturbed or lack of sleep, isolation, inactivity, low self-esteem, guilt, disturbed eating patterns, and overwhelming feelings. Most of the available instruments assess almost these entire characteristics, so it is essential to address them.
Tests and Instruments
Geriatric Depression Scale
The most widely used screening tools for depression among the elderly is the Geriatric Depression Scale (GDS). It is significant because of its validity and reliability (Guerin et al., 2018). GDS is a screening test that helps in the identification of depression symptoms in the aged group. Patients answer questions in a yes/no format. The questions asked how a high connection with depressive symptoms such as enjoyment level interest and social interaction, among others. The patient needs to be evaluated further if they get a score of 5 or above. This tool's significant advantage is it is easy and quick, taking less than 7 minutes to complete. However, its challenge is that it has been observed that some people may extend the time further as they may want to expound further regarding their issues. The assessor, therefore, has a duty of redirecting the patient back to the question time and again. Similarly, some people are too much into a depression that they find it difficult to answer the question, while others do not wish to answer some personal questions.
PHQ9
One of the most valuable tests is depression screening, also known as PHQ9. This is a criteria-based diagnosis of depressive disorder that is very reliable and valid in measuring the symptoms of depression. The is nin ...
1
3
Test Development Proposal: Step One
Jane Doe
The University of Arizona Global Campus
RES7402: Advanced Tests & Measurements (QAH114DS)
Dr. John Doe
April 5, 2021
Test Development Proposal: Step One
Bushnell et al. 2019, describes depression disorder as disorder that affects an individual's mood, usually making them has an unrelenting feeling of sadness and interest loss (p.908). The condition leads to a variety of physical and emotional problems. The patients, therefore, experience trouble doing day-to-day activities. Older adults and women are at a high risk of this condition. Understanding the complexities 0f depression, diagnosis, and treatment has never been more critical, whether developing a better understanding of depression to an individual’s personal life, a team, and an organization that directly impacts communities. A better understanding of depression is also fundamental in offering innovative leadership ideas on handling this condition. This is especially very important because data illustrates that there are a lot of deaths that are attributed to depression.
In this construct, various characteristics can be assessed, but I will be assessing the symptoms of this condition in this case. Various characteristics are present to people suffering from this condition. Some of the characteristics include feelings of sadness and interest loss, suicidal tendencies, disturbed or lack of sleep, isolation, inactivity, low self-esteem, guilt, disturbed eating patterns, and overwhelming feelings. Most of the available instruments assess almost these entire characteristics, so it is essential to address them.
Tests and Instruments
Geriatric Depression Scale
The most widely used screening tools for depression among the elderly is the Geriatric Depression Scale (GDS). It is significant because of its validity and reliability (Guerin et al., 2018). GDS is a screening test that helps in the identification of depression symptoms in the aged group. Patients answer questions in a yes/no format. The questions asked how a high connection with depressive symptoms such as enjoyment level interest and social interaction, among others. The patient needs to be evaluated further if they get a score of 5 or above. This tool's significant advantage is it is easy and quick, taking less than 7 minutes to complete. However, its challenge is that it has been observed that some people may extend the time further as they may want to expound further regarding their issues. The assessor, therefore, has a duty of redirecting the patient back to the question time and again. Similarly, some people are too much into a depression that they find it difficult to answer the question, while others do not wish to answer some personal questions.
PHQ9
One of the most valuable tests is depression screening, also known as PHQ9. This is a criteria-based diagnosis of depressive disorder that is very reliable and valid in measuring the symptoms of depression. The is nin ...
Please I need a response to this case study.1 pagezero plagi.docxcherry686017
Please I need a response to this case study.
1 page
zero plagiarism
three references
The Case:
The sleepy woman with anxiety
This week’s discussion presents a case study involving a 44-year old woman with a chief complaint of anxiety beginning at age 15 years old. She has a long history of mental illness and continued therapies. The purpose of this discussion is to analyze her case history to determine medication and treatment effectiveness.
Client Questions
Question 1. Are you having feelings of harming yourself or harming someone else?
Rationale: This is a possibly uncomfortable yet important set of questions to ask each client. Primary care providers may be in a unique position to prevent suicide due to their frequent interactions with suicidal patients. Reviews suggest that among patients who committed suicide, 80 percent had contact with primary care clinicians within one year of their death, whereas only 25 to 30 percent of decedents had contact with psychiatric clinicians within the year of their death (Stene-Lars & Reneflot, 2017).
Question 2. What was happening in your life as a teenager when the anxiety started and you began to self-medicate?
Rationale: Per our report, this patient began suffering signs and symptoms of anxiety at 15-years old. Asking these types of questions we may gain insight into an underlying cause or triggering event. Anxiety disorders are the most common psychiatric disorders with onset in childhood, with prevalence estimates ranging from 10 to 30 percent. Nearly 37 percent of behaviorally inhibited preschool-age children had social anxiety disorder at age 15, compared with 15 percent of non- behaviorally inhibited children
.
Children with anxiety disorders are more likely to have persistent anxiety disorders into adulthood. (Rapee, 2014).
Question 3. What was happening in your life a year ago when these symptoms returned and became debilitating? Let’s discuss what the triggering events may have been.
Rationale: Self-discovery of triggering events may help the client to come to terms with the determinants of her anxiety and depression. Studies have shown that specific types of stressors were found to differentially predict increases in specific facets of anxiety sensitivity; health-related stressors predicted increases in disease-related concerns and fear of mental incapacitation, whereas stressors related to family discord predicted increases in fear of feeling unsteady, fear of mental incapacitation, and fear of having publicly observable symptoms of anxiety (McLaughlin & Hatzenbuehler, 2009).
Support System
The support system as reported by our client is her husband. She states he is supportive and has little to no contact with the family of origin. She has a few friends and a few outside interests. As PMHNP, discussing relationships with the client is one avenue to gain insight into anxiety patterns and coping mechanisms as seen by outside support. With the client’s permissio.
Discussion 1 EvertonGenerate a primary and differential diagnoVinaOconner450
Discussion 1 Everton
Generate a primary and differential diagnosis using the DSM-5 criteria.
Based on the fact that J.T has verbally stated he feels depressed with many negative thoughts, has been very stressed out with school, he does not spend time with others but rather alone, has been skipping classes, declining invites for activities and isolating himself more would align more with his primary diagnosis being major depressive disorder. J.T. is also avoiding reality and seems to no longer be concentrated on the important things in his life. For J.T., the differential diagnosis would be anxiety vs obsessive compulsive disorder. He is very doubtful and does not seem to feel like he is complete or even capable of being around new people without thinking that they think he is less of a person. His own thoughts cause him to almost panic and not think clearly to the point he starts to stutter. When moments like that happens, he replays those moments over and over again causing him to be even more afraid.
Develop a biopsychosocial plan of care for this client.
The biopsychosocial plan of care for J.T. would be to see what medications could be prescribed to him to see they could uplift his mood. Hopefully that will help him avoid isolating himself and seek out to teachers and attend class and to also accept invitations from friends. In addition, seeing what therapy sessions could help, teaching him some distraction methods such as meditating to see if that would help to relieve his stress and allow him to focus more on thinking positive towards things including school. Suggesting or referring him to group therapies with others that are in college possibly experiencing the same stress, anxiety and depression to see if that would also help him relax.
Compare and contrast fear, worry, anxiety, and panic.
Fear is an immediate response to something that one may feel threatened by. Fear is a learned response that triggers the amygdala in the brain to work. When a person becomes fearful of something or someone it triggers the nervous system where cortisol and adrenaline are released causing an increase in the person’s heart rate and blood pressure (Northwestern Medicine, 2020). This is called the fight or flight response which can either cause someone to not be able to make clear decisions or think clearly. The fight or flight response can also cause the person to gain pleasure out of this fear as well (Northwestern Medicine, 2020). Anxiety is also a fight or flight response to something or someone that causes fear or worry. Anxiety can lead to a panic depending on the severity of the anxiety or feelings or fear and worry. Anxiety can be caused by personal life experiences or medical conditions (Mayo Clinic, 2018). According to Mayo Clinic (2018), no matter what type of anxiety or what causes the patient to become anxious, anxiety always has a treatment. Worry is a form of thinking that can lead to fear, anxiety, and panic. Panic is considered to be ...
Running Head: PSYCHIATRIC DIAGNOSIS
PSYCHIATRIC DIAGNOSIS 4
Psychiatric disorders are the medical conditions that affect the patient’s mental state or
the functioning of the brain. There are several psychiatric conditions and they affect the patients
differently one of the main ones is the anxiety disorder. The psychiatric disorder is a mental
health condition that is normally characterised with and some kind of fear that is so strong to the
point of affecting an individual’s way of thinking in the daily activities. This disorder can relate
quite easily to the symptoms identified in the diagnostic manual as the person’s state way of
thinking changes generally and the individual is not in a position to make sound decisions. The
manual has outlined the symptoms like stress, the patient not being able to set aside worry in
whatever condition (Musante & Ropers, 2014).
The diagnostic for this condition involves looking out for the open symptoms like
uncontrollable stress level. The nurse of the medical practitioner attending to the patient may
also try to interrogate the patient to find out if they can reason out issues with a composed or
simply a sober mind. In the case of the analytical diagnosis it is quite apparent the manner the
patient was acting in relation to the various symptoms of the disorder. The diagnosis manual has
outlined some main symptoms of this disorder like abnormal level of stress, and significant level
of worry as they respond to the diagnosis process. There are several symptoms that have been
outlined in this diagnostic manual. There was some diagnostic that were outlined in this manual
like the restlessness.
The particular diagnostic manual that was outlined in case was the most appropriate one
for this condition and it was focusing on the main symptoms of the disorder making it quite easy
to distinct or single out the disorder from other similar mental conditions. There is some specific
diagnostic manual that seem to be so general and would make it quite challenging for one to
relate to the disorder and so would be confusing (Anttila, Bulik-Sullivan, Finucane, Walters,
Bras, Duncan & Patsopoulos, 2018).
When it comes to summarizing the diagnosis to critically outline the theoretical
orientation is quite critical and the historical perspective. There are several psychiatric disorders
that have related or similar symptoms and may be quite confusing. It is therefore important to
include the theoretical and historical perspectives to try and clear any cases of doubt in the
condition. This is a theoretical orientation and the historical perspective which are normally
specific to the disorder. These conditions are sometimes passed genetically and so looking into
the history to verify the condition and to clear any cases of doub.
ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH 2
Evidence Based Practice Grant Proposal
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Grant Proposal-Assessing the role of stigma towards mental health patients in help seeking
Study problem
There are several studies that have shown that stigmatization towards mental health patients have been present throughout history and even despite the evolution in modern medicine and advanced treatment. For example, Verhaeghe et al., (2014), captures in a publication in reference to a study that he conducted that stigmatization towards mental health patients has been there even as early is in the 18th Century. People were hesitant to interact with people termed or perceived to have mental health conditions.
Stigmatization has resulted from the belief that those with mental problem are aggressive and dangerous creating a social distance (Szeto et al., 2017). Also, mental health-related stigma has become of major concern as it creates crucial barriers to access treatment and quality care since it not only influences the behaviour of the patients but also the attitude of the providers hence impacting help-seeking. Timmermann, Uhrenfeldt and Birkelund (2014), have identified stigma as a barrier that is of significance to care or help seeking while the extent to which it still remains a barrier have not been reviewed deeply. Therefore, this study will assess the role contributed by stigma in help seeking in depth. 1. Purpose
The intention of the research study is to review the association between stigma, mental illness and help seeking in order to formulate ways in which the stigma that is around mental health is done away with to enable as many people suffering from mental health complications to seek medical help.2. Background
Mental health is crucial in every stage of life. It is defined as the state of psychological well-being whereby the individual realizes a satisfactory integration instinctual drive acceptable to both oneself and his or her social setting (Ritchie & Roser, 2018). The status of mental health influences physical health, relationships, and most importantly day-to-day life. Mental health problems arise when there is a disruption in mental well-being.
The risk factors to mental health problems are not limited and therefore everyone is entitled to the problem irrespective of gender, economic status, and ethnic group. For example, data shows that in America one out of five individuals experience mental health problems annually; with mental disorders being recognized as the leading cause of disability not only in the United States but also globally (Ritchie & Roser, 2018). Mental health disorders are seen to be complex and of many forms such as anxiety, mood, and schizophren.
My Role Salesforce DeveloperMy Working Client Truck Rental Com.docxroushhsiu
My Role: Salesforce Developer
My Working Client: Truck Rental Company
Purpose:
This assignment is a written assignment where students will demonstrate how this course research has connected and put into practice within their own career.
Description:
Provide a reflection of at least 500 words (2 pages double spaced) of how the knowledge, skills, or theories of this course have been applied, or could be applied, in a practical manner to your current work environment.
Deliverable:Prepare a 2 page (excluding title and reference page) APA styled Microsoft Word document that shares a personal connection that identifies specific knowledge and theories from this course as well as demonstrates a connection to your current work environment.
Critique the decision making of two of your peers in your response posts.
1. Do you agree/disagree with their medication choice? Why?
2. Is there anything else you recommend including?
3. Compare peer's decision making to yours—what are the advantages and disadvantages of each?
Your response should include evidence of review of the course material through proper citations using APA format.
Reply one:
1)Psychosis: Again, the diagnosis of schizophrenia is best made over time because repeated observations increase the reliability of the diagnosis. A diagnosis of schizophrenia is reached through an assessment of patient-specific signs and symptoms, as described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Schizophrenia presents with four symptom clusters: positive, negative, cognitive, and affective disturbances. Positive symptoms can include hallucinations, delusions, thought disorders/behaviors, and movement disorders. Negative symptoms include a flat affect, alogia, anhedonia, lack of self-motivation, social withdrawal. Cognitive symptoms include poor executive function, difficulty focusing, memory deficits. And finally, affective disturbances include odd expressions or actions, poor self-esteem, depression with an increased risk of suicide (Dunphy, Winland-Brown, Porter, & Thomas, 2011).
The diagnostic criteria for schizophrenia include the persistence of two or more of the following active-phase symptoms, each lasting for a significant portion of at least a one-month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms. At least one of the qualifying symptoms must be delusions, hallucinations, or disorganized speech (DSM-5, 2013). Patient Andy presents with delusions, auditory/cenesthetic hallucinations, and increasing social withdrawal extending upon two months. As well, an estimated 80% of clients affected by a psychotic disorder experience their first episode between the ages of 16-30. In men, the symptoms tend to present between 18 and 25 years of age. In women, the onset of symptoms has two peaks, the first between 25 years of age and the mid-30s, and the second after 40 years of age (Hol ...
The Impact of Ethnicity on Anti-depressant TherapyThe Case .docxrtodd33
The Impact of Ethnicity on Anti-depressant Therapy
The Case: The man whose antidepressant stopped working.
Gathering information on physical assessment is essential in the management and treatment of the patient’s conditions like depression. The participation of a family is vital in the overall treatment of a person who has a mental disorder.
The three questions necessary to ask the patient with depression are: “How do you feel about being retired?” ; “Can you tell me about your family?”; and “ Are you having thoughts of harming yourself?” The first question will explore the extent of financial demand on the patient and will assess the feeling of guilt regarding financial constraints related to his chronic disease. The importance of financial challenge appeared as the primary stressor on the study on chronic disease and depression (Chan & Corvin, 2016). The second question determines how family relations affect the patient’s condition, whether he has a sound support system. The third question explores the patient's plan for himself.
The patient’s wife in the scenario is his support person. Family and social interactions appeared crucial to coping strategy even without resolution on the problem (Chan & Corvin, 2016). The following questions are necessary to determine how supportive is the patient’s wife: “Do you keep track of your husband’s medication regimen?” ; “ What are the things that you and your husband like to do?”; and “How do you feel about your husband’s illness?”
The first question determines the wife’s involvement in patient care and whether the patient is compliant with his schedules of medication. The second question explore the things that both patient and wife enjoy. The third question assesses how the patient’s wife handles his husband’s illness. The wife can be a husband’s caregiver, and such a job involves managing the patient’s treatment, side effects, and symptoms, which providing such care can be emotionally difficult (Nik Jaafar et al., 2014). Greater caregiver burden is associated with older adults with long-standing depressive manifestations (Marshe et al., 2017).
Physical Examination and Diagnostic Tests
Physical assessment on the patient’s head, thyroid, and nervous system is an appropriate action to rule out other causes of depression. Current studies affirmed a significant correlation between thyroid hormone imbalance in patients with MDD (Shen et al., 2019). The result of a physical examination will enable the provider to treat any condition that might have contributed to the patient’s depression. The patient may also benefit from HAM-D6 or melancholia sub-scale. The HAM-D6 is a focused version of the Hamilton Depression Rating Scale (HAM-D), an outcome measure in MDD (Dunlop et al., 2019). The test result helps identify the effect of an antidepressant (Dunlop et al., 2019). The result is beneficial and helpful in medication decision management.
Three Differential Diagnosis
The three differential diagn.
Due Facilitating group to post by Day 1; all other AlyciaGold776
Due: Facilitating group to post by
Day 1; all other students post to discussion prompt by
Day 3 and one other peer initial discussion prompt post by
Day 6
Initial Post: Created by Facilitating Group ( I am not in the facilitating group)
This is a student-led discussion.
· The facilitating group should choose one member from their group who will be responsible for the initial post.
· On
Day 1 of this week, the chosen group member will create an initial post that is to include the group's discussion prompts, resources, and the instructions for what your classmates are to do with the resources.
· During this week, each member of your group is to participate in the facilitation of the discussion. This means making certain that everyone is engaged, questions from students are being answered, and the discussion is expanding.
· It is the expectation that the facilitating group will address all initial peer response posts by Day 7.
Reply Posts: Non-Facilitating Students
· If you are not a member of the facilitating group, you are to post a discussion prompt response according to the facilitating group's instructions by
Day 3. Your reply posts should include substantive reflection directed to the presenters.
· You are also expected to respond to at least two other peer's initial discussion prompt posts.
Group Facilitated Discussion Plan: Attention Deficit Hyperactivity Disorder
Yanisleidy Mondeja and Laura Richard
NU664C Family Mental Health I
Attention Deficit Hyperactivity Disorder
This post entails an alliance of ideas and research blended to inspire a lively discussion entailing Attention Deficit Hyperactivity Disorder (ADHD) among children and adolescents. ADHD is one of the most common mental disorders affecting children and adolescents. Thomas et al. (2015) affirm that it is a common neurobehavioral disorder, with approximately 11% of children aged 4 to 17years being diagnosed in the United States alone. The presence of geographical differences affects the rate of diagnosis and treatment in which prevalence has increased over time. Considering the fifth edition of DSM-V, for an individual to be diagnosed with ADHD, one must meet six out of nine possible inattentive symptoms such as failing to give close attention to details or being easily distracted. This is alongside the six out of nine possible hyperactivity or impulsivity symptoms such as being on the ego or difficulty for an individual to wait for his turn. Moreover, symptoms need to be present for at least six months, occur in two different settings, be present before 12 years of age, and not be better explained by another disorder (Painter & Scannapieco, 2021).
Attention Deficit-Hyperactivity Disorder has three presentations: predominantly hyperactive/impulsive, predominantly inattentive, and a combination of the two based on how many symptoms in each diagnostic category a person meets. ...
Running head and connection to substance abuse1comorbidity an.docxtoddr4
Running head: and connection to substance abuse 1
comorbidity and connection to substance abuse 6Literature Review
Comorbidity and Its Connection to Substance Abuse, Treatment, and Relapse
Paula King
Walden University
Capstone
Dr. Jane Lyons
June 23, 2019
Comorbidity and Its Connection to Substance Abuse, Treatment, and Relapse
Comorbidity is considered as two or more conditions that occur in one person. These disorders can happen one after another or at the same time. Comorbidity has a strong connection with substance abuse, treatment, as well as relapse (Kelly & Daley, 2013). It is essential to note that many of those who suffer from substance use disorder usually develop other mental disorders, which is a similar case to many of those diagnosed with mental disorders. Research indicates that about half of those experiencing mental illnesses have a high probability of experiencing substance abuse disorders at some time in their life. Some few research have been conducted on children, and the result indicates that youths with substance abuse disorder typically have a high rate of co-occurring mental diseases like anxiety and depression (Child, 2012). Clinicians must find an effective way to treat individuals with substance use and addictions mental health disorders. To be effective they need to prescribe the right medication to treat alcohol, opioid, and nicotine addiction and there are also medications to alleviate symptoms of mental disorders. There are some behavioral therapies that have promise in treating comorbid conditions. The programs are tailored for the clients according to age, drug misused, and other factors, which can be used alone or with medication. Some effective therapies for treating comorbid conditions: cognitive behavioral therapy, Dialectical therapy, assertive community treatment, therapeutic communities, and contingency management (Kelly & Daley, 2013).
According to Woody and Blaine (1979) for over 25 years there has been a correlation between substance abuse illnesses and other mental disorders is not a visible indication that one resulted in another, albeit one came after another. Understanding the directionality or causality can sometimes be difficult because of different reasons. For instance, emotional or behavior issues may not be severe enough to raise the alarm for diagnosis. However, sub-clinical mental health concerns may prompt abuse of drugs. The main factors that contribute to comorbidity between mental illnesses and drug abuse disorders include the aspect of conventional risk factors, the possibility of mental diseases contributing to addiction and drug abuse, and the possibility of drug abuse and addiction contributing to the growth of mental health disorders (Bukstein & Horner, 2015). Drug use and mental health illnesses can result from coinciding aspects such as epigenetic and genetic exposures, concerns with related parts of the brain, and environmental factors.
Running Head ADVANCED NURSING RESEARCH1ADVANCED NURSING RES.docxtoddr4
Running Head: ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH
4
Advanced Nursing Research (Research Study)
Student Name
Institution-Affiliated
Different Parts of a Research Study
Research topic
A systematic review of the association between stigma and or on help-seeking among mental health patients.
Research Problem
Stigma or the process of labelling, discrimination and prejudice towards individuals suffering from mental health problems is considered to have numerous adverse consequences compared to the health conditions themselves according to Thornicroft, Mehta, Clement, Evans-Lacko, Doherty, Rose & Henderson, (2016). In addition, research has found stigma to be responsible for the failure of numerous individuals suffering from mental health to seek help from both their close relatives or trusted individuals and from healthcare providers (Clement, Schauman, Graham, Maggioni, Evans-Lacko, Bezborodovs, Thornicroft, 2015).
Given an increase in mental health disorders and the challenges that such disorders pose to both individuals and society, numerous studies have been conducted to examine the association between stigma and help-seeking among mental health patients. However, research has largely focused on the attitudes that constitute stigma towards mental health patients and little on the interventions required to reduce or eradicate stigma. Moreover, since the failure to reduce stigma prevents mental health patients from seeking help and hence worsening their conditions, there is need for further studies regarding the association between stigma and help-seeking and the need to reduce stigma making the study not only relevant but significant.
Research purpose
The purpose of this paper is to explore the association between stigma and help-seeking among mental health patients and to identify proven strategies or actionable recommendation for reducing stigma.
Research objectives
The objective of the study will be to (1) Explore the extent to which stigma posses a barrier to help-seeking among mental health patients, (2) Identify whether stigma affects certain populations more than others and (3) propose strategies that can help reduce stigma.
Research question
The study will aim to answer the following questions (1) What is the association between stigma towards mental health patients and help-seeking? (2) To what extent does stigma constitute a barrier to the search for help among mental health patients and (3) Are there populations that are more deterred from seeking help due to stigma?
Research hypothesis
Ho: Stigma towards mental health patients deters them from seeking help
Ha: There is no association between stigma and the search for help among mental health patients.
In addition, the study hypothesizes that a reduction in stigma would result in increased help-seeking among mental health patients.
References
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., ... & Thornicroft, G. (2.
12-15 page paper with 5 slide PowerPoint on an current management .docxAlyciaGold776
12-15 page paper with 5 slide PowerPoint on an current management issue, MY ISSUES:
(OPEN COMMUNICATION)
PAPER WILL BE SUBMITTED TO TURNIN!
APA, (6
TH
ED.) paper has to included title page& table of content
No pronouns
Cite all quantitative data
Cite all quotes ( try not to use quotations)
Intro ½ page
Background ¾ page
Literature review 4-5 page
Analysis 3-4 page ( detailed information)
Conclusion ¾ page ( WHAT,WHY,HOW,WHOM)
References page-Minimum of 20 published scholarly sources current as possible
Abstract (these questions has to be answered)
Clear statement of problem or issue
Methods or procedures summarized
Results summarized
Conclusions summarized
DUES BY MAY28 5PM
.
12Working With FamiliesThe Case of Carol and JosephCa.docxAlyciaGold776
12
Working With Families:
The Case of Carol and Joseph
Carol is a 23-year-old, heterosexual, Caucasian female and the
mother of a 1-year-old baby girl. She is currently unemployed,
having previously worked for a house cleaning company. The
baby is healthy and developmentally on target, and she and the
parents appear to be well bonded with one another. Carol lives in
a rented house with her husband, Joseph. Joseph is a 27-year-old,
heterosexual, Hispanic male. He was recently arrested at their
home for a drug deal, which he asserts was a setup. Both parents
were charged with child endangerment because weapons were
found in the child’s crib and drugs were found in the home. The
parents assert that the child never sleeps in the crib but in their
bed. As a result of the parents’ arrest, social services was notified,
and the child was temporarily placed in a kinship care arrangement
with the maternal grandmother, who resides nearby. As a
result of Joseph’s arrest, he was fired from the cleaning company
where he worked, and the family is now experiencing financial
difficulties.
After initial contact was made with the parents, a number of
concerns were noted and the family was recommended for additional
case management. Carol’s mother indicated that she had
concerns about Carol’s drinking habits and stated that Carol’s
father and grandfather were alcoholics. She and the father separated
when Carol was a baby, and Carol has had only limited
contact with him. There appears to be significant tension between
the grandmother and Carol and Joseph. I addressed the alcohol
issue with both parents, who denied there was a problem, but
shortly after the discussion, Carol was involved in a serious car
accident with the baby in the car. She was determined to have been
under the influence of alcohol. I advised Carol that she could not
have any unsupervised contact with her child until she completed
intensive inpatient substance abuse treatment. I made arrangements
for her placement, but after a week, she was discharged
for noncompliance with the rules. She was then referred to an
intensive outpatient program and began therapy there. Initially
her attendance was erratic because she had lost her license as a
result of the DUI. Eventually, however, she became engaged in the
program and began to address her issues. She acknowledged that
she had started using drugs at a very young age but said that she
had only begun drinking in the previous year or so. We discussed
the genetics of her family, and she said that she realized that she
had deteriorated rapidly since beginning to drink and knew that
she simply could not drink alcohol.
Joseph’s mother is deceased, and his father travels extensively
in his job and is not available as a support. Joseph was
very devoted to his mother and was devastated by her premature
death. We discussed the strengths that he and Carol demonstrated
in staying together and working out their p.
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Bushnell et al. 2019, describes depression disorder as disorder that affects an individual's mood, usually making them has an unrelenting feeling of sadness and interest loss (p.908). The condition leads to a variety of physical and emotional problems. The patients, therefore, experience trouble doing day-to-day activities. Older adults and women are at a high risk of this condition. Understanding the complexities 0f depression, diagnosis, and treatment has never been more critical, whether developing a better understanding of depression to an individual’s personal life, a team, and an organization that directly impacts communities. A better understanding of depression is also fundamental in offering innovative leadership ideas on handling this condition. This is especially very important because data illustrates that there are a lot of deaths that are attributed to depression.
In this construct, various characteristics can be assessed, but I will be assessing the symptoms of this condition in this case. Various characteristics are present to people suffering from this condition. Some of the characteristics include feelings of sadness and interest loss, suicidal tendencies, disturbed or lack of sleep, isolation, inactivity, low self-esteem, guilt, disturbed eating patterns, and overwhelming feelings. Most of the available instruments assess almost these entire characteristics, so it is essential to address them.
Tests and Instruments
Geriatric Depression Scale
The most widely used screening tools for depression among the elderly is the Geriatric Depression Scale (GDS). It is significant because of its validity and reliability (Guerin et al., 2018). GDS is a screening test that helps in the identification of depression symptoms in the aged group. Patients answer questions in a yes/no format. The questions asked how a high connection with depressive symptoms such as enjoyment level interest and social interaction, among others. The patient needs to be evaluated further if they get a score of 5 or above. This tool's significant advantage is it is easy and quick, taking less than 7 minutes to complete. However, its challenge is that it has been observed that some people may extend the time further as they may want to expound further regarding their issues. The assessor, therefore, has a duty of redirecting the patient back to the question time and again. Similarly, some people are too much into a depression that they find it difficult to answer the question, while others do not wish to answer some personal questions.
PHQ9
One of the most valuable tests is depression screening, also known as PHQ9. This is a criteria-based diagnosis of depressive disorder that is very reliable and valid in measuring the symptoms of depression. The is nin ...
1
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Test Development Proposal: Step One
Jane Doe
The University of Arizona Global Campus
RES7402: Advanced Tests & Measurements (QAH114DS)
Dr. John Doe
April 5, 2021
Test Development Proposal: Step One
Bushnell et al. 2019, describes depression disorder as disorder that affects an individual's mood, usually making them has an unrelenting feeling of sadness and interest loss (p.908). The condition leads to a variety of physical and emotional problems. The patients, therefore, experience trouble doing day-to-day activities. Older adults and women are at a high risk of this condition. Understanding the complexities 0f depression, diagnosis, and treatment has never been more critical, whether developing a better understanding of depression to an individual’s personal life, a team, and an organization that directly impacts communities. A better understanding of depression is also fundamental in offering innovative leadership ideas on handling this condition. This is especially very important because data illustrates that there are a lot of deaths that are attributed to depression.
In this construct, various characteristics can be assessed, but I will be assessing the symptoms of this condition in this case. Various characteristics are present to people suffering from this condition. Some of the characteristics include feelings of sadness and interest loss, suicidal tendencies, disturbed or lack of sleep, isolation, inactivity, low self-esteem, guilt, disturbed eating patterns, and overwhelming feelings. Most of the available instruments assess almost these entire characteristics, so it is essential to address them.
Tests and Instruments
Geriatric Depression Scale
The most widely used screening tools for depression among the elderly is the Geriatric Depression Scale (GDS). It is significant because of its validity and reliability (Guerin et al., 2018). GDS is a screening test that helps in the identification of depression symptoms in the aged group. Patients answer questions in a yes/no format. The questions asked how a high connection with depressive symptoms such as enjoyment level interest and social interaction, among others. The patient needs to be evaluated further if they get a score of 5 or above. This tool's significant advantage is it is easy and quick, taking less than 7 minutes to complete. However, its challenge is that it has been observed that some people may extend the time further as they may want to expound further regarding their issues. The assessor, therefore, has a duty of redirecting the patient back to the question time and again. Similarly, some people are too much into a depression that they find it difficult to answer the question, while others do not wish to answer some personal questions.
PHQ9
One of the most valuable tests is depression screening, also known as PHQ9. This is a criteria-based diagnosis of depressive disorder that is very reliable and valid in measuring the symptoms of depression. The is nin ...
Please I need a response to this case study.1 pagezero plagi.docxcherry686017
Please I need a response to this case study.
1 page
zero plagiarism
three references
The Case:
The sleepy woman with anxiety
This week’s discussion presents a case study involving a 44-year old woman with a chief complaint of anxiety beginning at age 15 years old. She has a long history of mental illness and continued therapies. The purpose of this discussion is to analyze her case history to determine medication and treatment effectiveness.
Client Questions
Question 1. Are you having feelings of harming yourself or harming someone else?
Rationale: This is a possibly uncomfortable yet important set of questions to ask each client. Primary care providers may be in a unique position to prevent suicide due to their frequent interactions with suicidal patients. Reviews suggest that among patients who committed suicide, 80 percent had contact with primary care clinicians within one year of their death, whereas only 25 to 30 percent of decedents had contact with psychiatric clinicians within the year of their death (Stene-Lars & Reneflot, 2017).
Question 2. What was happening in your life as a teenager when the anxiety started and you began to self-medicate?
Rationale: Per our report, this patient began suffering signs and symptoms of anxiety at 15-years old. Asking these types of questions we may gain insight into an underlying cause or triggering event. Anxiety disorders are the most common psychiatric disorders with onset in childhood, with prevalence estimates ranging from 10 to 30 percent. Nearly 37 percent of behaviorally inhibited preschool-age children had social anxiety disorder at age 15, compared with 15 percent of non- behaviorally inhibited children
.
Children with anxiety disorders are more likely to have persistent anxiety disorders into adulthood. (Rapee, 2014).
Question 3. What was happening in your life a year ago when these symptoms returned and became debilitating? Let’s discuss what the triggering events may have been.
Rationale: Self-discovery of triggering events may help the client to come to terms with the determinants of her anxiety and depression. Studies have shown that specific types of stressors were found to differentially predict increases in specific facets of anxiety sensitivity; health-related stressors predicted increases in disease-related concerns and fear of mental incapacitation, whereas stressors related to family discord predicted increases in fear of feeling unsteady, fear of mental incapacitation, and fear of having publicly observable symptoms of anxiety (McLaughlin & Hatzenbuehler, 2009).
Support System
The support system as reported by our client is her husband. She states he is supportive and has little to no contact with the family of origin. She has a few friends and a few outside interests. As PMHNP, discussing relationships with the client is one avenue to gain insight into anxiety patterns and coping mechanisms as seen by outside support. With the client’s permissio.
Discussion 1 EvertonGenerate a primary and differential diagnoVinaOconner450
Discussion 1 Everton
Generate a primary and differential diagnosis using the DSM-5 criteria.
Based on the fact that J.T has verbally stated he feels depressed with many negative thoughts, has been very stressed out with school, he does not spend time with others but rather alone, has been skipping classes, declining invites for activities and isolating himself more would align more with his primary diagnosis being major depressive disorder. J.T. is also avoiding reality and seems to no longer be concentrated on the important things in his life. For J.T., the differential diagnosis would be anxiety vs obsessive compulsive disorder. He is very doubtful and does not seem to feel like he is complete or even capable of being around new people without thinking that they think he is less of a person. His own thoughts cause him to almost panic and not think clearly to the point he starts to stutter. When moments like that happens, he replays those moments over and over again causing him to be even more afraid.
Develop a biopsychosocial plan of care for this client.
The biopsychosocial plan of care for J.T. would be to see what medications could be prescribed to him to see they could uplift his mood. Hopefully that will help him avoid isolating himself and seek out to teachers and attend class and to also accept invitations from friends. In addition, seeing what therapy sessions could help, teaching him some distraction methods such as meditating to see if that would help to relieve his stress and allow him to focus more on thinking positive towards things including school. Suggesting or referring him to group therapies with others that are in college possibly experiencing the same stress, anxiety and depression to see if that would also help him relax.
Compare and contrast fear, worry, anxiety, and panic.
Fear is an immediate response to something that one may feel threatened by. Fear is a learned response that triggers the amygdala in the brain to work. When a person becomes fearful of something or someone it triggers the nervous system where cortisol and adrenaline are released causing an increase in the person’s heart rate and blood pressure (Northwestern Medicine, 2020). This is called the fight or flight response which can either cause someone to not be able to make clear decisions or think clearly. The fight or flight response can also cause the person to gain pleasure out of this fear as well (Northwestern Medicine, 2020). Anxiety is also a fight or flight response to something or someone that causes fear or worry. Anxiety can lead to a panic depending on the severity of the anxiety or feelings or fear and worry. Anxiety can be caused by personal life experiences or medical conditions (Mayo Clinic, 2018). According to Mayo Clinic (2018), no matter what type of anxiety or what causes the patient to become anxious, anxiety always has a treatment. Worry is a form of thinking that can lead to fear, anxiety, and panic. Panic is considered to be ...
Running Head: PSYCHIATRIC DIAGNOSIS
PSYCHIATRIC DIAGNOSIS 4
Psychiatric disorders are the medical conditions that affect the patient’s mental state or
the functioning of the brain. There are several psychiatric conditions and they affect the patients
differently one of the main ones is the anxiety disorder. The psychiatric disorder is a mental
health condition that is normally characterised with and some kind of fear that is so strong to the
point of affecting an individual’s way of thinking in the daily activities. This disorder can relate
quite easily to the symptoms identified in the diagnostic manual as the person’s state way of
thinking changes generally and the individual is not in a position to make sound decisions. The
manual has outlined the symptoms like stress, the patient not being able to set aside worry in
whatever condition (Musante & Ropers, 2014).
The diagnostic for this condition involves looking out for the open symptoms like
uncontrollable stress level. The nurse of the medical practitioner attending to the patient may
also try to interrogate the patient to find out if they can reason out issues with a composed or
simply a sober mind. In the case of the analytical diagnosis it is quite apparent the manner the
patient was acting in relation to the various symptoms of the disorder. The diagnosis manual has
outlined some main symptoms of this disorder like abnormal level of stress, and significant level
of worry as they respond to the diagnosis process. There are several symptoms that have been
outlined in this diagnostic manual. There was some diagnostic that were outlined in this manual
like the restlessness.
The particular diagnostic manual that was outlined in case was the most appropriate one
for this condition and it was focusing on the main symptoms of the disorder making it quite easy
to distinct or single out the disorder from other similar mental conditions. There is some specific
diagnostic manual that seem to be so general and would make it quite challenging for one to
relate to the disorder and so would be confusing (Anttila, Bulik-Sullivan, Finucane, Walters,
Bras, Duncan & Patsopoulos, 2018).
When it comes to summarizing the diagnosis to critically outline the theoretical
orientation is quite critical and the historical perspective. There are several psychiatric disorders
that have related or similar symptoms and may be quite confusing. It is therefore important to
include the theoretical and historical perspectives to try and clear any cases of doubt in the
condition. This is a theoretical orientation and the historical perspective which are normally
specific to the disorder. These conditions are sometimes passed genetically and so looking into
the history to verify the condition and to clear any cases of doub.
ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH 2
Evidence Based Practice Grant Proposal
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Grant Proposal-Assessing the role of stigma towards mental health patients in help seeking
Study problem
There are several studies that have shown that stigmatization towards mental health patients have been present throughout history and even despite the evolution in modern medicine and advanced treatment. For example, Verhaeghe et al., (2014), captures in a publication in reference to a study that he conducted that stigmatization towards mental health patients has been there even as early is in the 18th Century. People were hesitant to interact with people termed or perceived to have mental health conditions.
Stigmatization has resulted from the belief that those with mental problem are aggressive and dangerous creating a social distance (Szeto et al., 2017). Also, mental health-related stigma has become of major concern as it creates crucial barriers to access treatment and quality care since it not only influences the behaviour of the patients but also the attitude of the providers hence impacting help-seeking. Timmermann, Uhrenfeldt and Birkelund (2014), have identified stigma as a barrier that is of significance to care or help seeking while the extent to which it still remains a barrier have not been reviewed deeply. Therefore, this study will assess the role contributed by stigma in help seeking in depth. 1. Purpose
The intention of the research study is to review the association between stigma, mental illness and help seeking in order to formulate ways in which the stigma that is around mental health is done away with to enable as many people suffering from mental health complications to seek medical help.2. Background
Mental health is crucial in every stage of life. It is defined as the state of psychological well-being whereby the individual realizes a satisfactory integration instinctual drive acceptable to both oneself and his or her social setting (Ritchie & Roser, 2018). The status of mental health influences physical health, relationships, and most importantly day-to-day life. Mental health problems arise when there is a disruption in mental well-being.
The risk factors to mental health problems are not limited and therefore everyone is entitled to the problem irrespective of gender, economic status, and ethnic group. For example, data shows that in America one out of five individuals experience mental health problems annually; with mental disorders being recognized as the leading cause of disability not only in the United States but also globally (Ritchie & Roser, 2018). Mental health disorders are seen to be complex and of many forms such as anxiety, mood, and schizophren.
My Role Salesforce DeveloperMy Working Client Truck Rental Com.docxroushhsiu
My Role: Salesforce Developer
My Working Client: Truck Rental Company
Purpose:
This assignment is a written assignment where students will demonstrate how this course research has connected and put into practice within their own career.
Description:
Provide a reflection of at least 500 words (2 pages double spaced) of how the knowledge, skills, or theories of this course have been applied, or could be applied, in a practical manner to your current work environment.
Deliverable:Prepare a 2 page (excluding title and reference page) APA styled Microsoft Word document that shares a personal connection that identifies specific knowledge and theories from this course as well as demonstrates a connection to your current work environment.
Critique the decision making of two of your peers in your response posts.
1. Do you agree/disagree with their medication choice? Why?
2. Is there anything else you recommend including?
3. Compare peer's decision making to yours—what are the advantages and disadvantages of each?
Your response should include evidence of review of the course material through proper citations using APA format.
Reply one:
1)Psychosis: Again, the diagnosis of schizophrenia is best made over time because repeated observations increase the reliability of the diagnosis. A diagnosis of schizophrenia is reached through an assessment of patient-specific signs and symptoms, as described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Schizophrenia presents with four symptom clusters: positive, negative, cognitive, and affective disturbances. Positive symptoms can include hallucinations, delusions, thought disorders/behaviors, and movement disorders. Negative symptoms include a flat affect, alogia, anhedonia, lack of self-motivation, social withdrawal. Cognitive symptoms include poor executive function, difficulty focusing, memory deficits. And finally, affective disturbances include odd expressions or actions, poor self-esteem, depression with an increased risk of suicide (Dunphy, Winland-Brown, Porter, & Thomas, 2011).
The diagnostic criteria for schizophrenia include the persistence of two or more of the following active-phase symptoms, each lasting for a significant portion of at least a one-month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms. At least one of the qualifying symptoms must be delusions, hallucinations, or disorganized speech (DSM-5, 2013). Patient Andy presents with delusions, auditory/cenesthetic hallucinations, and increasing social withdrawal extending upon two months. As well, an estimated 80% of clients affected by a psychotic disorder experience their first episode between the ages of 16-30. In men, the symptoms tend to present between 18 and 25 years of age. In women, the onset of symptoms has two peaks, the first between 25 years of age and the mid-30s, and the second after 40 years of age (Hol ...
The Impact of Ethnicity on Anti-depressant TherapyThe Case .docxrtodd33
The Impact of Ethnicity on Anti-depressant Therapy
The Case: The man whose antidepressant stopped working.
Gathering information on physical assessment is essential in the management and treatment of the patient’s conditions like depression. The participation of a family is vital in the overall treatment of a person who has a mental disorder.
The three questions necessary to ask the patient with depression are: “How do you feel about being retired?” ; “Can you tell me about your family?”; and “ Are you having thoughts of harming yourself?” The first question will explore the extent of financial demand on the patient and will assess the feeling of guilt regarding financial constraints related to his chronic disease. The importance of financial challenge appeared as the primary stressor on the study on chronic disease and depression (Chan & Corvin, 2016). The second question determines how family relations affect the patient’s condition, whether he has a sound support system. The third question explores the patient's plan for himself.
The patient’s wife in the scenario is his support person. Family and social interactions appeared crucial to coping strategy even without resolution on the problem (Chan & Corvin, 2016). The following questions are necessary to determine how supportive is the patient’s wife: “Do you keep track of your husband’s medication regimen?” ; “ What are the things that you and your husband like to do?”; and “How do you feel about your husband’s illness?”
The first question determines the wife’s involvement in patient care and whether the patient is compliant with his schedules of medication. The second question explore the things that both patient and wife enjoy. The third question assesses how the patient’s wife handles his husband’s illness. The wife can be a husband’s caregiver, and such a job involves managing the patient’s treatment, side effects, and symptoms, which providing such care can be emotionally difficult (Nik Jaafar et al., 2014). Greater caregiver burden is associated with older adults with long-standing depressive manifestations (Marshe et al., 2017).
Physical Examination and Diagnostic Tests
Physical assessment on the patient’s head, thyroid, and nervous system is an appropriate action to rule out other causes of depression. Current studies affirmed a significant correlation between thyroid hormone imbalance in patients with MDD (Shen et al., 2019). The result of a physical examination will enable the provider to treat any condition that might have contributed to the patient’s depression. The patient may also benefit from HAM-D6 or melancholia sub-scale. The HAM-D6 is a focused version of the Hamilton Depression Rating Scale (HAM-D), an outcome measure in MDD (Dunlop et al., 2019). The test result helps identify the effect of an antidepressant (Dunlop et al., 2019). The result is beneficial and helpful in medication decision management.
Three Differential Diagnosis
The three differential diagn.
Due Facilitating group to post by Day 1; all other AlyciaGold776
Due: Facilitating group to post by
Day 1; all other students post to discussion prompt by
Day 3 and one other peer initial discussion prompt post by
Day 6
Initial Post: Created by Facilitating Group ( I am not in the facilitating group)
This is a student-led discussion.
· The facilitating group should choose one member from their group who will be responsible for the initial post.
· On
Day 1 of this week, the chosen group member will create an initial post that is to include the group's discussion prompts, resources, and the instructions for what your classmates are to do with the resources.
· During this week, each member of your group is to participate in the facilitation of the discussion. This means making certain that everyone is engaged, questions from students are being answered, and the discussion is expanding.
· It is the expectation that the facilitating group will address all initial peer response posts by Day 7.
Reply Posts: Non-Facilitating Students
· If you are not a member of the facilitating group, you are to post a discussion prompt response according to the facilitating group's instructions by
Day 3. Your reply posts should include substantive reflection directed to the presenters.
· You are also expected to respond to at least two other peer's initial discussion prompt posts.
Group Facilitated Discussion Plan: Attention Deficit Hyperactivity Disorder
Yanisleidy Mondeja and Laura Richard
NU664C Family Mental Health I
Attention Deficit Hyperactivity Disorder
This post entails an alliance of ideas and research blended to inspire a lively discussion entailing Attention Deficit Hyperactivity Disorder (ADHD) among children and adolescents. ADHD is one of the most common mental disorders affecting children and adolescents. Thomas et al. (2015) affirm that it is a common neurobehavioral disorder, with approximately 11% of children aged 4 to 17years being diagnosed in the United States alone. The presence of geographical differences affects the rate of diagnosis and treatment in which prevalence has increased over time. Considering the fifth edition of DSM-V, for an individual to be diagnosed with ADHD, one must meet six out of nine possible inattentive symptoms such as failing to give close attention to details or being easily distracted. This is alongside the six out of nine possible hyperactivity or impulsivity symptoms such as being on the ego or difficulty for an individual to wait for his turn. Moreover, symptoms need to be present for at least six months, occur in two different settings, be present before 12 years of age, and not be better explained by another disorder (Painter & Scannapieco, 2021).
Attention Deficit-Hyperactivity Disorder has three presentations: predominantly hyperactive/impulsive, predominantly inattentive, and a combination of the two based on how many symptoms in each diagnostic category a person meets. ...
Running head and connection to substance abuse1comorbidity an.docxtoddr4
Running head: and connection to substance abuse 1
comorbidity and connection to substance abuse 6Literature Review
Comorbidity and Its Connection to Substance Abuse, Treatment, and Relapse
Paula King
Walden University
Capstone
Dr. Jane Lyons
June 23, 2019
Comorbidity and Its Connection to Substance Abuse, Treatment, and Relapse
Comorbidity is considered as two or more conditions that occur in one person. These disorders can happen one after another or at the same time. Comorbidity has a strong connection with substance abuse, treatment, as well as relapse (Kelly & Daley, 2013). It is essential to note that many of those who suffer from substance use disorder usually develop other mental disorders, which is a similar case to many of those diagnosed with mental disorders. Research indicates that about half of those experiencing mental illnesses have a high probability of experiencing substance abuse disorders at some time in their life. Some few research have been conducted on children, and the result indicates that youths with substance abuse disorder typically have a high rate of co-occurring mental diseases like anxiety and depression (Child, 2012). Clinicians must find an effective way to treat individuals with substance use and addictions mental health disorders. To be effective they need to prescribe the right medication to treat alcohol, opioid, and nicotine addiction and there are also medications to alleviate symptoms of mental disorders. There are some behavioral therapies that have promise in treating comorbid conditions. The programs are tailored for the clients according to age, drug misused, and other factors, which can be used alone or with medication. Some effective therapies for treating comorbid conditions: cognitive behavioral therapy, Dialectical therapy, assertive community treatment, therapeutic communities, and contingency management (Kelly & Daley, 2013).
According to Woody and Blaine (1979) for over 25 years there has been a correlation between substance abuse illnesses and other mental disorders is not a visible indication that one resulted in another, albeit one came after another. Understanding the directionality or causality can sometimes be difficult because of different reasons. For instance, emotional or behavior issues may not be severe enough to raise the alarm for diagnosis. However, sub-clinical mental health concerns may prompt abuse of drugs. The main factors that contribute to comorbidity between mental illnesses and drug abuse disorders include the aspect of conventional risk factors, the possibility of mental diseases contributing to addiction and drug abuse, and the possibility of drug abuse and addiction contributing to the growth of mental health disorders (Bukstein & Horner, 2015). Drug use and mental health illnesses can result from coinciding aspects such as epigenetic and genetic exposures, concerns with related parts of the brain, and environmental factors.
Running Head ADVANCED NURSING RESEARCH1ADVANCED NURSING RES.docxtoddr4
Running Head: ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH
4
Advanced Nursing Research (Research Study)
Student Name
Institution-Affiliated
Different Parts of a Research Study
Research topic
A systematic review of the association between stigma and or on help-seeking among mental health patients.
Research Problem
Stigma or the process of labelling, discrimination and prejudice towards individuals suffering from mental health problems is considered to have numerous adverse consequences compared to the health conditions themselves according to Thornicroft, Mehta, Clement, Evans-Lacko, Doherty, Rose & Henderson, (2016). In addition, research has found stigma to be responsible for the failure of numerous individuals suffering from mental health to seek help from both their close relatives or trusted individuals and from healthcare providers (Clement, Schauman, Graham, Maggioni, Evans-Lacko, Bezborodovs, Thornicroft, 2015).
Given an increase in mental health disorders and the challenges that such disorders pose to both individuals and society, numerous studies have been conducted to examine the association between stigma and help-seeking among mental health patients. However, research has largely focused on the attitudes that constitute stigma towards mental health patients and little on the interventions required to reduce or eradicate stigma. Moreover, since the failure to reduce stigma prevents mental health patients from seeking help and hence worsening their conditions, there is need for further studies regarding the association between stigma and help-seeking and the need to reduce stigma making the study not only relevant but significant.
Research purpose
The purpose of this paper is to explore the association between stigma and help-seeking among mental health patients and to identify proven strategies or actionable recommendation for reducing stigma.
Research objectives
The objective of the study will be to (1) Explore the extent to which stigma posses a barrier to help-seeking among mental health patients, (2) Identify whether stigma affects certain populations more than others and (3) propose strategies that can help reduce stigma.
Research question
The study will aim to answer the following questions (1) What is the association between stigma towards mental health patients and help-seeking? (2) To what extent does stigma constitute a barrier to the search for help among mental health patients and (3) Are there populations that are more deterred from seeking help due to stigma?
Research hypothesis
Ho: Stigma towards mental health patients deters them from seeking help
Ha: There is no association between stigma and the search for help among mental health patients.
In addition, the study hypothesizes that a reduction in stigma would result in increased help-seeking among mental health patients.
References
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., ... & Thornicroft, G. (2.
12-15 page paper with 5 slide PowerPoint on an current management .docxAlyciaGold776
12-15 page paper with 5 slide PowerPoint on an current management issue, MY ISSUES:
(OPEN COMMUNICATION)
PAPER WILL BE SUBMITTED TO TURNIN!
APA, (6
TH
ED.) paper has to included title page& table of content
No pronouns
Cite all quantitative data
Cite all quotes ( try not to use quotations)
Intro ½ page
Background ¾ page
Literature review 4-5 page
Analysis 3-4 page ( detailed information)
Conclusion ¾ page ( WHAT,WHY,HOW,WHOM)
References page-Minimum of 20 published scholarly sources current as possible
Abstract (these questions has to be answered)
Clear statement of problem or issue
Methods or procedures summarized
Results summarized
Conclusions summarized
DUES BY MAY28 5PM
.
12Working With FamiliesThe Case of Carol and JosephCa.docxAlyciaGold776
12
Working With Families:
The Case of Carol and Joseph
Carol is a 23-year-old, heterosexual, Caucasian female and the
mother of a 1-year-old baby girl. She is currently unemployed,
having previously worked for a house cleaning company. The
baby is healthy and developmentally on target, and she and the
parents appear to be well bonded with one another. Carol lives in
a rented house with her husband, Joseph. Joseph is a 27-year-old,
heterosexual, Hispanic male. He was recently arrested at their
home for a drug deal, which he asserts was a setup. Both parents
were charged with child endangerment because weapons were
found in the child’s crib and drugs were found in the home. The
parents assert that the child never sleeps in the crib but in their
bed. As a result of the parents’ arrest, social services was notified,
and the child was temporarily placed in a kinship care arrangement
with the maternal grandmother, who resides nearby. As a
result of Joseph’s arrest, he was fired from the cleaning company
where he worked, and the family is now experiencing financial
difficulties.
After initial contact was made with the parents, a number of
concerns were noted and the family was recommended for additional
case management. Carol’s mother indicated that she had
concerns about Carol’s drinking habits and stated that Carol’s
father and grandfather were alcoholics. She and the father separated
when Carol was a baby, and Carol has had only limited
contact with him. There appears to be significant tension between
the grandmother and Carol and Joseph. I addressed the alcohol
issue with both parents, who denied there was a problem, but
shortly after the discussion, Carol was involved in a serious car
accident with the baby in the car. She was determined to have been
under the influence of alcohol. I advised Carol that she could not
have any unsupervised contact with her child until she completed
intensive inpatient substance abuse treatment. I made arrangements
for her placement, but after a week, she was discharged
for noncompliance with the rules. She was then referred to an
intensive outpatient program and began therapy there. Initially
her attendance was erratic because she had lost her license as a
result of the DUI. Eventually, however, she became engaged in the
program and began to address her issues. She acknowledged that
she had started using drugs at a very young age but said that she
had only begun drinking in the previous year or so. We discussed
the genetics of her family, and she said that she realized that she
had deteriorated rapidly since beginning to drink and knew that
she simply could not drink alcohol.
Joseph’s mother is deceased, and his father travels extensively
in his job and is not available as a support. Joseph was
very devoted to his mother and was devastated by her premature
death. We discussed the strengths that he and Carol demonstrated
in staying together and working out their p.
12 pages The papers must be typed (12 point font) in Times N.docxAlyciaGold776
1
2
pages
The papers must be typed (12 point font) in Times New Roman Font; double-spaced (unless otherwise noted), with one inch margins.
the organization should be a business or company basis.
Provide the links for the company's news.
You show up for work in a new organization or “parachute” into the organization (often knowing little about the organization).
This analytical paper describes how you observe and orient in this new environment to more fully understand the organization’s behavior.
address the deeper
currents of culture
as well as how
processes
and
mission
drive behavior.
address your place in this organization (from which perspective are you writing), not merely from a “job description” perspective, but from at the individual and group levels of analysis.
While not limited to these topics
address leadership, motivation, communications, and ethics.
In addition to incorporating
a wide variety of specific OB distinctions from the course
, the paper must
analyze
(not merely describe) the organization’s behavior from each zoom level:
individual, group, organization, and inter-organizational.
t
h
ird-person perspective
to analyze the organization.
The paper requires you to think deeply about OB in a specific organization.
use an organization you have experience with or research one where you would like to work.
Ideally, from reading this paper, professor should have the experience of being there with you and gain a valuable understanding of this organization.
Another way to look at this paper is as the document which uncovers the currents of organizational behavior in a methodical way.
The exercise of writing this paper provides you with a template for analyzing your next organization’s behavior, to avoid organizational pitfalls, and more quickly make a valuable contribution.
Organizational behavior concepts include: (analyze at least 8 concepts below from
individual, group, organization, and inter-organizational as well as the culture perspective
)
Diversity
Attitudes and Job Satisfaction
Emotions and Moods
Personality and Values
Perception and Individual Decision Making
Motivation Concepts and Application
Foundations of Group Behavior & Understanding Work Teams
Communication
Leadership
Inter-Organizational Behavior
Power and Politics
Conflict and Negotiation
Foundations of Organizational Structure
Organizational Culture
Organizational Change and Stress Management
.
12 new times roman 4-6 pages double spaced apply ONE of t.docxAlyciaGold776
12 new times roman
4-6 pages
double spaced
apply ONE of the theories listed below to
The Jack-Roller: A Delinquent Boys Own Story
by Clifford R. Shaw book.
Then make prediction on what happened to Stanley (protagonist of the book) BASED on the theory chosen.
Follow the guidelines CAREFULLY
Theories to choose from
·
Gottfredson and Hirschi: Self-Control Theory
·
Sampson and Laub: Age-graded Theory of Informal Social Control
·
Moffitt: Developmental Taxonomy
.
112016 @1000 a.m. 100 percent original 400-600 words with at leas.docxAlyciaGold776
11/20/16 @10:00 a.m. 100 percent original 400-600 words with at least 2 references APA format
To further support the acquisition of a new electronic health record (EHR) system, the chief information officer (CIO) has asked you, as an information technology (IT) manager, to meet with the nursing department heads to summarize the differences and the application of relational and object-oriented databases within an EHR system.
.
10–12 slides (not incl. title or ref slides) with speakers notes.docxAlyciaGold776
10–12 slides (not incl. title or ref slides) with speaker's notes
In learning about energy sources and non-fossil fuel sources, multiple technological advances were identified. These can reduce people's footprint on the planet and reduce the burden on fossil fuels.
Using already existing technology, describe ways in which people could reduce the need for external electrical and heat energy.
In completing this, you should be able to create a house that does not rely on public utilities.
Think of houses that exist in remote areas, where these public services do not reach; how can this be accomplished?
Be sure to include primary sources as well as ensure that your references are documented on the slides as they are being used. It is critical that your presentation tells a story, and is not prescribed by the prompts listed above.
.
11.1 - write a servlet that uses doGet to return a markup document t.docxAlyciaGold776
11.1 - write a servlet that uses doGet to return a markup document that provides your name, electronic mail address, and mailing address, along with a brief autobiography. test your servlet with a simple markup document.
11.2 write a servlet that returns a randomly chosen greeting from a list of five different greeting. The greetings must be stored as constant strings in the program.
.
10–15 slides with 150–200 words in the notes page.Using all 3 .docxAlyciaGold776
10–15 slides with 150–200 words in the notes page.
Using all
3 Financial Statements
(See attachment) please provide an analysis on Apix’s
assets, liabilities, cash, and profit
. As well, choose
2 additional components
on each of the sheets, and provide your initial impression on the company financial situation.
Need done by Monday morning.
Thanks Friend
.
12-20 slides needed for the business plan report provided. (SEE ATT.docxAlyciaGold776
12-20 slides needed for the business plan report provided. (SEE ATTACHED FILE) This is a new bar called Wonderland, presentation needs to be eye capturing and intriguing to make people want to buy in to the idea to make a reality.
Format
Powerpoint presentation
APA
Reference slides needed
SECOND ATTACHED FILE (PPT PRESENTATION) SHOWS HOW I STARTED IT
I posted wrong file
.
1000+ word essay MLA styleTopic Judging others is human nature..docxAlyciaGold776
1000+ word essay MLA style
Topic
: Judging others is human nature. Some of us may practice fighting the urge to be judgmental more than others, but it is a very active battle. What lessons can you argue the characters from “ A Good Man Is Hard To Find by Flannery Oconnor” and “Young Goodman Brown by Nathaniel Hawthorne” teach readers regarding the dangers of being judgmental?
Please use these strategy questions as the professor is looking for them to be addressed in the writing.
Do you have a lead-in to “hook” your reader? (an example, anecdote, scenario, startling statistic, or provocative question.)
How much background is required to properly acquaint readers with your issue?
Will your claim be placed early (introduction) or delayed (conclusion) in your paper?
What is your supporting evidence?
Have you located authoritative (expert) sources that add credibility to your argument?
Have you considered addressing opposing viewpoints?
Are you willing to make some concessions (compromises) toward opposing sides?
What type of tone (serious, comical, sarcastic, inquisitive) best relates your message to reach your audience?
One written, have you maintained a third person voice? (no “I” or “you” statements)
How will you conclude in a meaningful way? (call your readers to take action, explain why the topic has a global importance, or offer a common ground compromise that benefits all sides?)
I wanted to make the instructions clear so I am not penalized when it comes to grading.
All paragraphs should have a topic sentence and supporting sentences explaining one idea and not multiple ideas.
Things I got hit on, on past papers on here.
Intro
Opposition
Supporting argument
Conclusion
Works cited page
looking for an A+
also have a 2000 word research paper coming up soon that i'm willinng to pay good for will be posting soon
.
1000 - 1500 words in APA format. Draft Final PlanYou work for a p.docxAlyciaGold776
1000 - 1500 words in APA format. Draft /Final Plan
You work for a popular consumer electronics company that sells products such as cell phones, tablets, and personal computers. The vice president of operations has talked to you about setting up a warehousing and distribution process that can support business expansions globally. He has asked you to develop a recommendation that will help build a business plan. You need to focus on the areas of transportation regulations and policies, transportation methodologies, warehousing, distribution, and inventory management.
The company is looking to start its global expansion in the European Union and China. You will focus your analysis and recommendations for this report on importing goods into those areas from the United States and fulfilling customer orders from in-region warehousing or distribution centers. Your outline should include the following:
Part I:
Transportation Regulations and Policies
Define the goal
Explain the relevance
National security
Public safety
Environment
Unrestrained competition
Part II:
Transportation Methodologies
Economic viability
Practical use
Applications in domestic and global markets
Part III:
Warehousing and Distribution
Principles
Design
Storage and handling
Information systems and information technology
Third-party logistics providers (3PL)
Part IV:
Inventory Management
Inventory functions for intermediate and final products
Packaging techniques
.
1000 words an 5 referencesResource Blossoms Up! Case Study .docxAlyciaGold776
1000 words an 5 references
Resource
: Blossoms Up! Case Study and Email No. 3
Numerous emails have been sitting in the HR Director's in-box for two months. Smith is highly agitated that none of his have been responded to. Now that you are hired, he has asked you to address the emails immediately.
Read
Email No. 3
concerning a report needed to respond to Smith's direction that the company have its own retirement plan such as a 401(k) plan, the laws affecting such plans, and what to do about funding it since the company is in a cost-cutting mode.
Complete
Smith's directions and the instructions in the email.
Use
headings to appropriately signal the topics and keep your document organized.
Use
a minimum of five in-text citation sources within your paper and identify them in your APA correctly formatted References page.
Click
the Assignment Files tab to submit your assignment.
.
1000+ word essay MLA styleTopic While Abraham Lincoln and John .docxAlyciaGold776
1000+ word essay MLA style
Topic:
While Abraham Lincoln and John F. Kennedy were superior national leaders, everyday persons also take on the responsibilities and risks of leadership, as illustrated by Robert, The blind man, in Raymond Carver’s “Cathedral”. On the other hand, Lieutenant Jimmy Cross in Tim O’Brien’s “the things they carried” believes he has neglected his duties as the leader of his platoon.
If you were conducting a leadership workshop for your college or local community, how could you use these four individuals to illustrate key points of your presentation? What other examples—contemporary or historical, fictional or factual—might you use to illustrate leadership qualities?
In doing so, consider the Core Value of Integrity emphasized in this course. This assignment asks you to address qualities of leadership. What is the relationship between integrity and leadership? Please include in your writing your own definition of Integrity and whether those in leadership roles are assumed to have (or demonstrate) integrity.
Please use these strategy questions as the professor is looking for them to be addressed in the writing.
Do you have a lead-in to “hook” your reader? (an example, anecdote, scenario, startling statistic, or provocative question.)
How much background is required to properly acquaint readers with your issue?
Will your claim be placed early (introduction) or delayed (conclusion) in your paper?
What is your supporting evidence?
Have you located authoritative (expert) sources that add credibility to your argument?
Have you considered addressing opposing viewpoints?
Are you willing to make some concessions (compromises) toward opposing sides?
What type of tone (serious, comical, sarcastic, inquisitive) best relates your message to reach your audience?
One written, have you maintained a third person voice? (no “I” or “you” statements)
How will you conclude in a meaningful way? (call your readers to take action, explain why the topic has a global importance, or offer a common ground compromise that benefits all sides?)
I wanted to make the instructions clear so I am not penalized when it comes to grading.
All paragraphs should have a topic sentence and supporting sentences explaining one idea and not multiple ideas.
Things I got hit on, on past papers on here.
Intro
Opposition
Supporting argument
Conclusion
Works cited page
.
1000 words and dont use the InternetFrom the book answer the qu.docxAlyciaGold776
1000 words and don't use the Internet
From the book answer the questions
A. Did any of these authors have followed historical methods of Said's book ( Orientalism) or subaltern historians? Please give an example to prove your argument.
B. How do these histories of non-westren women contribute to non-westten historiograph?
.
100 original 0 plagiarism, with introduction and conclusion.I.docxAlyciaGold776
100% original 0 plagiarism, with introduction and conclusion.
I need no more late than tomorrow Jun 6 at 7 pm.
Middle Childhood and Adolescence Paper
(
Addresses the issue in the Population of Puerto Rico. Discusses the cultural aspects that influence.)
Prepare a 950 word paper in which you describe changes that occur during middle childhood and adolescence concerning family and peer relationships, and how they might influence future development. Be sure to include the following items in your description:
Evaluate the effect of functional and dysfunctional family dynamics on development (e.g., family structure, function, and shared and nonshared environments).
Determine the positive and negative impact of peers and changes in peer relations from middle childhood to adolescence.
Examine additional pressures faced in adolescence compared to middle childhood.
Discuss the development of moral values from middle childhood into adolescence.
Use a minimum of two peer-reviewed sources.
Format your paper consistent with APA guidelines.
.
100 Original Work.Graduate Level Writing Required.DUE .docxAlyciaGold776
100% Original Work.
Graduate Level Writing Required.
DUE: Sunday, June 12, 2020 by 5pm Eastern Standard Time.
Background:
Views on justice impact many areas of criminal justice, including the concepts of fairness, equality, and impartiality, and influence the ethical standards you apply in various situations in the field. Your views on justice and how you act in situations will affect the opinions others have of you in the communities you serve. Views on justice also impact actions taken and decisions made that affect the wider population.
Write
a 1,150- to 1,400-word paper describing the origins of the concept of justice and how you believe they are defined today.
Include the following:
-Explain Aristotle’s ethical ideas of distributive and procedural justice.
-Compare substantive justice and procedural justice, including how procedural justice impacts wrongful convictions and moral perceptions of racial discrimination, such as the Central Park Five and the story of Brian Banks, a former football star.
-Explain how you understand justice as defined by today’s modern criminal justice agencies. Include reasoning and examples in your explanation to support your opinion.
Include at least four additional scholarly reference.
Format your paper consistent with APA guidelines
.
Must Be Graduate Level Writing
100% Original Work
.
10-1 Discussion Typical vs. Atypical DevelopmentThroughout this c.docxAlyciaGold776
10-1 Discussion: Typical vs. Atypical Development
Throughout this course, we have explored different aspects of development, and research has presented a variety of influences in the form of biological, social, emotional, and cognitive domains. At the end of nearly every chapter reading, a holistic position began to emerge that acknowledges the contribution by each domain. In our final discussion, reflect on whether a holistic approach is just as effective for accounting for atypical development as it is for typical development. Utilize examples from the course to support your position, or consider using an issue of atypical development to provide context (e.g., autism or antisocial behavior).
*******JUST NEEDS TO BE 2 TO 3 PARAGREAPHS WITH REFERENCES**********
.
100 words only 1 APA REFERENCEThe traditional approach for ide.docxAlyciaGold776
100 words only 1 APA REFERENCE
The traditional approach for identifying qualified applicants is often driven by old traditions like looking at resumes, degree, years of experience, and even looks. What other, more quantifiable measures might be used when hiring a new employee? Be specific.
.
100 Words minimumDiscussion TopicWhat is the difference betwe.docxAlyciaGold776
100 Words minimum
Discussion Topic:
What is the difference between “community intervention” and “intervention in the community”? How can health advocates thoroughly address each in, for example, public policymaking of one of the following (choose one and discuss or choose a health concern of your own liking):
Youth violence
Asthma in children
Walking track and other public access to exercise/fitness
Heart disease
Lack of availability of health food (in stores, restaurants, etc.)
.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Advantages and Disadvantages of CMS from an SEO Perspective
Due Facilitating group to post by Day 1; all other students post
1. Due: Facilitating group to post by Day 1; all other students post
to discussion prompt by Day 4 and one other peer initial
discussion prompt post by Day 7
Initial Post: Created by Facilitating Group ( I am not in the
facilitating group)
This is a student-led discussion.
· The facilitating group should choose one member from their
group who will be responsible for the initial post.
· On Day 1 of this week, the chosen group member will create
an initial post that is to include the group's discussion prompts,
resources, and the instructions for what your classmates are to
do with the resources.
· During this week, each member of your group is to participate
in the facilitation of the discussion. This means making certain
that everyone is engaged, questions from students are being
answered, and the discussion is expanding.
· It is the expectation that the facilitating group will address all
initial peer response posts by Day 7.
Reply Posts: Non-Facilitating Students
· If you are not a member of the facilitating group, you are to
post a discussion prompt response according to the facilitating
group's instructions by Day 4. Your reply posts should include
substantive reflection directed to the presenters.
· You are also expected to respond to at least two other peer's
initial discussion prompt posts.
2. Facilitating Group’s Post (to be replied)
Depression and Somatization Disorders
Barry Lynne, Brittany Stoken, and Jessica Murphy
NU664C: Psychiatric Mental Health Care of the Family I
November 1, 2021
Depression and Somatization Disorders
Hello Class,
Group 1 is assigned Depression and Somatization
Disorders to further discuss. Failure to adjust and modify
emotions cognitively while experiencing stress can ultimately
present an outcome of exaggerated physiological and behavioral
responses and amplify susceptibility to somatic disorders, such
as somatization (Davoodi, et al., 2019). Somatization Disorder
is the presentation of recurrent and multiple somatic complaints
of several years duration for which medical attention has been
sought but which do not derive from a specific physical disorder
(Swartz, Blazer, & George, 2012).
Please respond to the following questions:
1. When caring for a patient with somatization disorder, what
therapeutic interventions would you formulate (Allen,
Woolfolk, Escobar, Gara, and Hamer, 2006)?
2. How would you evaluate the success of your interventions
for a patient living with somatization?
Depression is an extremely serious mood disorder that effects
how you think, feel, and act. Symptoms range from mild to
severe including, feeling sad, loss of interest or pleasure,
change in appetite, trouble sleeping or getting too much sleep,
feeling worthless, difficulty concentrating, and thoughts of
death or suicide (American Psychiatric Association, 2021). To
3. be diagnosed with depression, symptoms must last at least two
weeks and present a change in level of functioning (National
Institute of Mental Health, 2021).
Please respond to the following questions:
1. After watching the short video, discuss what you’ve learned
about depression and has it changed your thoughts on what it is
like to live with depression?
2. What interventions and resources would you use for this
patient? How would you evaluate success of treatment?
3. What are a few ways to educate and reduce the stigma
around depression, so that individuals living with depression
receive the help when symptoms first present?
Adolescents are experiencing depression at a rapidly growing
rate and the use of psychopharmacology and therapy has not
slowed this increase (Henjie Blom et al., 2016). Although there
are many potential causes for this increase, one of the primary
causes is the increased prevalence of social media and its
popular use amongst teens. Research has shown a direct link
between social media and depression and suicidality in
adolescents (Vidal et al., 2020). Though social medical has been
linked to depression within this population, just simply
decreasing the use and frequency of social media can have a
positive impact and greatly decrease psychological distress
(Radovic et al., 2017).
1. What additional non-pharmacological interventions would
you recommend for the adolescent patient with depression?
2. Which medication would be the appropriate choice for this
patient? What important patient education would you provide?
References
Allen LA, Woolfolk RL, Escobar JI, Gara MA, Hamer RM.
Cognitive-
Behavioral Therapy for Somatization Disorder:
A Randomized Controlled Trial. Arch Intern
Med. 2006;166(14):1512–
1518. doi:10.1001/archinte.166.14.1512
American Psychiatric Association. (2021). What is
4. depression? https://www.psychiatry.org/patients-
families/depression/what-is-depressio
Davoodi, E., Wen, A., Dobson, K. S., Noorbala, A. A.,
Mohammadi, A., & Farahmand, Z. (2019).
Emotion Regulation Strategies in Depression and
Somatization Disorder. Psychological
Reports, 122(6), 2119–
2136. https://doi.org/10.1177/0033294118799731
Henje Blom, E., Ho, T. C., Connolly, C. G., LeWinn, K. Z.,
Sacchet, M. D., Tymofiyeva, O., Weng, H.
Y., & Yang, T. T. (2016). The neuroscience and context
of adolescent depression. Acta
paediatrica (Oslo, Norway : 1992), 105(4), 358–365.
National Institute of Mental Health
(2021). Depression. https://www.nimh.nih.gov/health/topics
/depression
Radovic, A., Gmelin, T., Stein, B. D., & Miller, E. (2017).
Depressed adolescents' positive and
negative use of social media. Journal of adolescence,
55, 5–15.
Swartz, M. S., Blazer, D., & George, L. (2012). Somatization
disorder in a community population.
American Journal of Psychiatry, 143, 1403–1408.
Vidal, C., Lhaksampa, T., Miller, L., & Platt, R. (2020). Social
media use and depression in
adolescents: a scoping review. International review of
psychiatry (Abingdon, England),
32(3), 235–253.
Peer Post 1 (To be replied)
Week 10 Assignment: Respond to Group 1
5. Jeffrey Pham
November 2, 2021
1. When caring for a patient with somatization disorder, what
therapeutic interventions would you formulate (Allen,
Woolfolk, Escobar, Gara, and Hamer, 2006)?
2. How would you evaluate the success of your interventions
for a patient living with somatization?
Somatization disorder presents a challenge to healthcare as the
complaints of bodily distress have no objective or identifiable
cause (Kumar & Jahan, 2020). The The intervention for this
type of client should begin my ensuring that the somatizati on
disorders are distinguished from actual medical symptoms so
that intervention can be accurately implemented to address the
problematic issues. According to DSM-5, the diagnostic criteria
for somatization disorder are as followed: somatic symptoms are
persistent and lasts longer than 6 months, one or more somatic
distress symptoms that cause significant impairment in
functioning, and one or more excessive behaviors, thoughts
and//or feelings that is associated with somatic symptoms or
associated with various health problems (Henningsen, 2018).
The severity of this disorder is on a continuum from mild to
severe, depending on the numbers of somatic complaints and on
the DSM-5 diagnostic criteria; having multiple somatic
complaints and having multiple DSM-5 criteria met for
somatization lead to more severe form of the disorder
(Henningsen, 2018). To manage this condition appropriately,
first requires screening for it. The PHQ-15 is a screening tool to
detect for risk for somatic symptom disorder and have been
demonstrated to effectively screen and monitor for the disorder
(American Psychiatric Association, 2013). Antidepressants,
such as Tricyclic has been demonstrated to have some moderate
efficacy over newer antidepressant in treatment of somatization
while multimodal psychotherapy program has been shown to
significantly improve and manage somatic symptoms (Kumar &
6. Jahan, 2020; Henningsen, 2018). Interventions of somatic
symptoms management can be evaluated by using the PHQ-15 to
initially screen for and then to evaluate for any improvements in
symptoms from baseline (Kocalevent et al., 2013).
1. After watching the short video, discuss what you’ve learned
about depression and has it changed your thoughts on what it is
like to live with depression?
2. What interventions and resources would you use for this
patient? How would you evaluate success of treatment?
Depressive symptoms are associated with long duration and
presence of sadness, irritability, or anhedonia (Kaltenboech &
Harmer, 2018). According to Stahl (2013) major depressive
disorder is formulated when a client has prolonged periods of
depressed mood or loss of interest and with greater or equal to
at least 4 additional symptoms, such as suicidal ideation, sleep
disturbances, appetite changes, fatigue, guilt, and executive
dysfunction. The development of depression is complex, and
neuro-research has related to abnormalities of certain
monoamines, which include serotonin, noradrenaline and
dopamine, to the pathogenesis of depression (Kaltenboech &
Harmer, 2018). Brain imaging has shown that there is
decreased serotonin transmission activity in certain parts of the
brain in depressive individuals while increasing serotonergic
activity by administering antidepressants help relieve those
symptoms and support the monoamine theory as relate to
depression (Kaltenboech & Harmer, 2018). Given the fact that
untreated depression is associated with functional impairment,
such as poor quality of life and loss of work productivity and
increased risks for suicide, it is extremely important to treat
depression (Culpepper et al., 2015).
While the goal of treating depression is to achieve full
remission, the task begins by identifying depression,
administering treatment, and finally evaluating treatment
response. There are several tools available to aid in identifying
7. and evaluating treatment response and/or resistance, such tools
include the 17-item Hamilton Rating Scale of Depression
(HAM-D) and the Patient Health Questionnaire-9 (PHQ-9)
(Culpepper et al., 2015). While treatment remission is
considered less or equal to 7 score on the Ham-D and less than
5 on the PHQ-9, full recovery is met when the client is in full
remission though the treatment has been discontinued
(Culpepper et al., 2015).
While the neurobiological monoamine theory of depression
includes a deficient or dysfunction in certain neurotransmitters,
it is logical to replace these neurotransmitters where it is
impaired or deficient (Stahl, 2013). A group of medications
known as SSRIs can provide more of the neurochemicals in the
synaptic cleft in order to bind with the post-synaptic neurons to
improve mood and depressive thoughts (Stahl, 2013). While
medications have been shown to effectively treat depression,
psychotherapeutic has been linked to increased resilience,
improvements in mood and physical and cognitive functioning
(Eddington et al., 2017). While medications may be helpful,
some may benefit from psychotherapeutic alone or as an adjunct
therapy to medications.
Additionally, Given the different profiles of antidepressants,
when approach with treatment option for an individual who has
clinical depression, there are factors to consider upon selecting
the antidepressant medications, such as but not limited to
tolerability, current medicine with consideration for drug-drug
interactions, psychiatric/medical comorbidities, efficacy of
prior treatments and cost of the medications (Culpepper et al.,
2015).
3. What are a few ways to educate and reduce the stigma
around depression, so that individuals living with depression
receive the help when symptoms first present?
The ways to educate and reduce the stigma around depression
are to first understand how stigma is defined and how it is
8. socially constructed, and in what ways has it created barrier to
accessing care for depression. According to Stuart (2016),
stigma is created when there are several parts interacting: first a
particular human is distinguished as different; second,
distinguished difference is attached to unwanted features,
creating a biased that apply to every person of that member;
third, they are seen as different from the dominant culture;
fourth, the biased or stigmatized members are devalued and
systematically disadvantaged, creating a disadvantaged group
that leads to their poor health outcomes.
There are several research and methods to help combat
stigma in mental health. Some of them include literacy
education to improve education about mental health; protest to
object and denounce stigma, to attempt to change organizational
behaviors; advocacy to support strategies aim at tackling
inequities designed by social structures that limit rights of
people with mental health issues (Stuart, 2016). These are just
some interventions that may be used to advocate for the mental
health population.
1. What additional non-pharmacological interventions would
you recommend for the adolescent patient with depression?
2. Which medication would be the appropriate choice for this
patient? What important patient education would you provide?
Just as in adult, an adolescence with mild to moderate
depressive symptoms may benefit from psychotherapy initially
(Gautam, 2017). CBT and interpersonal therapy have been
shown to be the most efficacious for managing depression,
however, the types of therapy that are most effective is
contingent upon how the client is responding (Gautam, 2017).
In moderate to severe depression, SSRIs are considered first
line for treating children and adolescents’ depression;
specifically, fluoxetine has the most evidence for use in
children and adolescents depression and it is also FDA approved
to treat children 8 years and older (Mullen, 2018).
9. When prescribing to this population, education regarding risk
for triggering suicidal ideation must be provided as there is an
FDA black box warning to all antidepressants that it may
increase the risk for suicidal ideation in children, adolescents,
and young adults (Mullen, 2018).
References
American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental disorders (5th ed.) (DSM-5).
Washington, DC: APA Press.
Culpepper, L., Muskin, R. P., & Stahl, S. M. (2015). Major
depressive disorder: Understanding the significance of residual
symptoms and balancing efficacy with tolerability. The
American journal of medicine. 128 (9), 1-15. DOI:
https://doi.org/10.1016/j.amjmed.2015.07.001
Eddington, K. M., Burgin, C. J., Silvia, P. J., Fallah, N.,
Majestic, C., & Kwapil, T. R. (2017). The Effects of
Psychotherapy for Major Depressive Disorder on Daily Mood
and Functioning: A Longitudinal Experience Sampling
Study. Cognitive therapy and research, 41(2), 266–277.
https://doi.org/10.1007/s10608-016-9816-7
Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S.
(2017). Clinical Practice Guidelines for the management of
Depression. Indian journal of psychiatry, 59(Suppl 1), S34–S50.
https://doi.org/10.4103/0019-5545.196973
Henningsen, P. (2018). Management of somatic symptom
disorder. Dialogues in clinical neuroscience, 20(1), 23–31.
https://doi.org/10.31887/DCNS.2018.20.1/phenningsen
Kaltenboeck, A., & Harmer, C. (2018). The neuroscience of
depressive disorders: A brief review of the past and some
considerations about the future. Brain and Neuroscience
Advances. 2: 1-6. https://doi.org/10.1177/2398212818799269
Kocalevent, R. D., Hinz, A. & Brähler, E. (2013).
Standardization of a screening instrument (PHQ-15) for
somatization syndromes in the general population. BMC
Psychiatry 13,91. https://doi.org/10.1186/1471-244X-13-91
10. Kumar, R., & Jahan, M. (2020). Multimodal psychotherapy in
the management of somatization disorder. Industrial psychiatry
journal, 29(2), 205–212. https://doi.org/10.4103/ipj.ipj_11_17
Mullen, S. (2018). Major depressive disorder in children and
adolescents. The mental health clinician, 8(6), 275–283.
https://doi.org/10.9740/mhc.2018.11.275
Stahl, S. M. (2013). Stahl's Essential Psychopharmacology:
Neuroscientific Basis and Practical Applications. 4th ed. New
York, NY: Cambridge University Press.
Stuart, H. (2016). Reducing the stigma of mental illness. Global
mental health (Cambridge, England), 3, e17.
https://doi.org/10.1017/gmh.2016.11
Peer Post 2 (To be replied)
Deborah Penny
Thank you Group 1 (Barry, Brittany, and Jessica). Your
presentation about somatization disorder and depression, along
with the video, and references will elicit excellent discussion
points. Somatization Disorder (SD) is “characterized by the
patient experiencing numerous physical symptoms that are
unrelated to any specific disease state or organ system; usually,
symptoms are unrelated, multiple, and difficult to measure”
(Zakhari, 2021, p. 193). For example, on page 191 of Zakhari,
question #18 states, “A 50-year-old woman referred from the
surgical service is described as a “frequent flyer”. She reports
vague complaints that have no apparent cause or objective
clinical findings. Most recently she complains of vaginal pain,
headache, and stomachache. Upon interview she is tearful,
guarded, and withdrawn. What is the most likely psychiatric
diagnosis?”
A. Malingering
B. Conversion disorder
C. Somatization disorder
D. Factitious Disorder
11. The correct answer is C. Somatization disorder because the
patient presents with many unrelated symptoms, all without
objective findings. Without objective findings, it is impossible
to develop a treatment plan. For example, if a patient presents
with a subjective symptom of a fever, but the objective finding
of afebrile rules it out, the patient’s subjective symptoms cannot
be substantiated.
1. When caring for a patient with somatization disorder, what
therapeutic interventions would you formulate?
Prior to Cognitive-Behavioral Therapy’s (CBT) success for
treating patients with SD utilized a consultation letter.
According to Boland et al (2021), a brief “consultation letter”
intended for primary care physicians demonstrated effectiveness
in improving patients’ functional capacity and decreased their
utilization of health services, essentially using boundaries as
part of the treatment. The letter provided guidance on the best
practice for treating patients with SD by seeing patients only
during regular business hours, providing focused physical
examinations, and avoiding unnecessary diagnostic procedures,
invasive treatments, and hospitalizations” (Boland, et al, 2021).
However, the most recent evidence-based success comes from
using CBT which focuses on stress management, activity
regulation, emotional awareness, cognitive restructuring, and
interpersonal communication.
2. How would you evaluate the success of your interventions
for a patient living with somatization?
Successful interventions are based on achieving the goals
developed between the patient and the provider. For example,
if the goal was to adhere to cognitive behavioral therapy
sessions, diary keeping, and a limited number of office visits
per month, these interventions would be successful, and the goal
achieved.
1. After watching the short video, discuss what you’ve learned
about depression and has it changed your thoughts on what it is
like to live with depression?
Depression can overtake every aspect of a person’s life and it
12. can cause a person to take their own life by suicide. Depression
is insidious, it can creep up on a person and take hold little by
little until a person loses the ability to reach out for help.
Several factors can play a role in depression: Biochemistry
(how the brain is wired), genetics (depression can run in
families), personality (low self-esteem can play a role), and
environmental factors (poverty, abuse, neglect). Because a
patient’s socioeconomic status can be a factor with depression,
a thorough biopsychosocial assessment is critical to the plan of
treatment. Research findings have indicated that lifestyle
behaviors and socioeconomic status were significantly
associated with psychological health, such as psychological
distress, depression, anxiety, and well-being” (Wang & Geng,
2019).
2. What interventions and resources would you use for this
patient? How would you evaluate success of treatment?
There are different types of therapy and interventions used to
treat depression. Cognitive behavioral therapy (CBT) works on
identifying negative thoughts and behaviors and replacing these
with more positive ones. Dialectic behavioral therapy (DBT)
helps to identify a person’s strengths, thoughts, and
assumptions. Successful treatment is defined on goals set by
the patient and therapist and is different for every individual
receiving help for their depression.
3. What are a few ways to educate and reduce the stigma around
depression, so that individuals living with depression receive
the help when symptoms first present?
Research has shown a direct link between social media and
depression and suicidality in adolescents (Vidal et al., 2020).
However, the same media that increases depression and anxiety
in adolescents can be the same one that reaches out and offers
hope and healing. “Stigma attached to mental illness appears to
be universal, it plays out indifferent ways according to local
contexts” (Stuart, 2016). Here are some websites that provide
help in different
ways: webmd.com, pickthebrain.com, Imalive.org,
13. and 7cups.com
1. What additional non-pharmacological interventions would
you recommend for the adolescent patient with depression?
“Cognitive behavioral therapy, naturopathic therapy, biological
interventions, and physical activity interventions reduced
depression severity. A shared decision-making approach is
needed to choose between non-pharmacological therapies based
on values, preferences, clinical and social context” (Farah,
2016).
2. Which medication would be the appropriate choice for this
patient? What important patient education would you provide?
“Selective serotonin reuptake inhibitors (SSRIs) would be a
place to start due to the mild side effects and the following
education would be provided” (Moreland & Bonin, 2016).
• The expected benefits and possible risks and side
effects
• The instructions for the dose and timing
• The expected length of time to response
• Potential interactions with other prescription or non-
prescription medications
• When prescribing to this population, education
regarding risk for triggering suicidal ideation must be provided
as there is an FDA black box warning to all antidepressants that
it may increase the risk for suicidal ideation in children,
adolescents, and young adults (Mullen, 2018).
Hanging indent not maintained
References
Allen, L. A., Woolfolk, R. L., Escobar, J. I., Gara, M. A., &
Hamer, R. M. (2006). Cognitive-behavioral therapy for
somatization disorder: a randomized controlled trial. Archives
of Internal Medicine,166(14), 1512–
1518. https://doi.org/10.1001/archinte.166.14.1512
Boland, R., Verduin, M., & Ruiz, P. (2021). Kaplan & Sadock’s
Synopsis of Psychiatry, 12th ed. Wolters Kluwer.
Farah, W. H., Alsawas, M., Mainou, M., Alahdab, F., Farah, M.
H., Ahmed, A. T., Mohamed, E.A., Almasri, J., Gionfriddo, M.
14. R., Castaneda-Guarderas, A., Mohammed, K., Wang, Z., Asi,
N., Sawchuk, C. N., Williams, M. D., Prokop, L. J., Murad, M.
H., & LeBlanc, A. (2016). Non-pharmacological treatment of
depression: a systematic review and evidence map. Evidence-
Based Medicine, 21(6), 214–
221. https://doi.org/10.1136/ebmed-2016-110522
Moreland, C. S., & Bonin, L. (2021). Patient education:
Depression treatment options for children and adolescents
(Beyond the
Basics). UpToDate. https://www.uptodate.com/contents/depres
sion-treatment-options-for-children-and- adolescents-
beyond-the-
basics?search=depression%20treatment%20adolescent&source=
search_result&selectedT
itle=10~150&usage_type=default&display_rank=10
Mullen, S. (2018). Major depressive disorder in children and
adolescents. The mental health clinician, 8(6), 275–
283. https://doi.org/10.9740/mhc.2018.11.275
Smith, G. R., Jr, Monson, R. A., & Ray, D. C. (1986).
Psychiatric consultation in somatization disorder. A randomized
controlled study. The New England Journal of Medicine,
314(22), 1407–1413.
https://doi.org/10.1056/NEJM198605293142203
Stuart, H. (2016). Reducing the stigma of mental illness. Global
mental health,3, e17.
https://doi.org/10.1017/gmh.2016.11
Vidal, C., Lhaksampa, T., Miller, L., & Platt, R. (2020). Social
media use and depression in adolescents: a scoping review.
International review of psychiatry, 32(3), 235–253.
Wang, J., & Geng, L. (2019). Effects of socioeconomic status
on physical and psychological health: Lifestyle as a mediator.
International journal of environmental research and public
health, 16(2),
281.https://doi.org/10.3390/ijerph16020281
Zakhari, R. (2021). The psychiatric-mental health nurse
practitioner certification review manual. Springer Publishing
15. Company, LLC.
Team assignment
Here is our team assignment for this week!
As a team, consider the following scenario:
On Dec. 7, 2000, the Cincinnati Occupational Safety and Health
Administration (OSHA) office heard through media and police
reports that there were two deaths at a nursing home in Ohio.
OSHA determined that the Food and Drug Administration
(FDA) should take a lead role in performing an investigation.
Because the nursing home had many residents who had
unhealthy respiratory systems, the nursing home routinely
ordered and received tanks that contained pure oxygen. During
one delivery, the supplier mistakenly delivered one tank of pure
nitrogen in addition to the three tanks of pure oxygen that had
been ordered. The nitrogen tank had both an oxygen and
nitrogen label. An employee at the nursing home connected the
nitrogen tank to the nursing home's oxygen delivery system.
This event caused two nursing home residents to die, and three
additional nursing home residents were admitted to hospitals in
critical condition. Within the following month, two of these
three additional residents also died, bringing the total death toll
to four. (Based on accident #837914 www.osha.gov)
Team compares the Normal Accident Theory to the Culture of
Safety model. Include the following in your paper:
MY PART
Write 300 word paper
· Explain actions that could have been taken to manage risk by
applying each of the five general principles used in the Culture