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Is the link between bipolar disorder and creativity one of coincidence, or are the two actually related?

Introduction

Society will always welcome the eccentric and the almost romanticised notion of the ‘mad genius’, with incomprehensible ramblings, fiery thoughts and feelings, who bears a startling capacity for novel thought. The heralded about notion of the ‘mad genius’ has become so typecast that the author of one review wrote ‘Creativity is not a kind of psychopathology!’ (1) This piece of work will explore the link between creativity and bipolar disorder. The famous and exuberant poet Lord Byron was one of those few ‘touched’ by the troublesome, cyclic and contrasting nature of manic-depressive illness (bipolar disorder) (2) This is a frightening affliction of disturbed gaieties, melancholy and chaotic temperament. The idea that fervent moods, illogical reasoning and an artistic temperament can be categorised together into a ‘fine madness’ is a controversial one. Most people would find the notion that an often psychotic, destructive and dangerous disease to convey certain ‘advantages’ such as powerful imagination, stronger emotional responses and an increase in energy, incomprehensible and counterintuitive.

This essay will try to explore the connection between bipolar disorder and creativity and deem whether it is creditable or not.

What is Bipolar Disorder?

Bipolar disorder is a disease of manic symptoms of varying severity. There are two types of bipolar disorder. Bipolar 1 affecting approximately 1% of the population is characterised by episodes of fully blown mania that can be accompanied by depression or not (mixed). This receives more concern and attention that it’s milder and more frequent form, type 2 bipolar prevalent in about 2.9% of the population (3). This is marked by less severe hypomanic and depressive episodes and ‘cyclothymia’, which is a swing between depressive and hypomanic states (hence the term ‘bipolar’ to highlight the contrast in mood and temperament). Cyclothymia affects about 4.2% of the population. (4). Examples of manic symptoms include elevated and sometimes irritable moods, an increased amount of energy, less need for sleep and bouts of insomnia, reckless and impaired judgement, an uncontrolled increase in promiscuity (which may lead to a disruption of the family unit) and thoughtless and foolish behaviours. When a person is going through a manic episode, they may feel more irascible and on edge and feel pressurized to keep talking or talk very fast with often-disconnected thought patterns. They may become more aware of their body and not be sure what to do with their hands when conversing so fidget more with them and wring them unnecessarily. During a manic episode, the person may also indulge in more extravagant behaviours that may cause regret later on such as spending a lot of money and drinking and eating in excess which may cause them to put on a bit of weight. (5). Usually, the extent of manic or depressive episodes varies from person to person. Some people may not even suffer from the typical manic symptoms or suffer from milder forms (hypomania). In contrast to mania, an example of depressive episodes are characterized by intense feelings of despair that can turn into feelings of desperation and hopelessness, memory impairment and episodes of amnesia, feelings of worthlessness, guilt, difficulty thinking and indecision. Other symptoms of a depressive episode include anhedonia (a loss of pleasure in acts that normally give pleasure), sleep and appetite disturbances, psychomotor retardation, loss of energy, recurrent and preoccupying thoughts of death (5). A crippling fatigue can take over that can last in duration from weeks to months and leave the person incapacitated to carry out even small tasks in a daily routine such as getting up to eat. On top of all this, the sufferer may be clueless as to why this is happening to them. Other things that affect the daily routine are daytime sleepiness making it hard for the person to socially interact and hold down a job – particularly one that requires good concentration.

As has been shown, this is a frightening and dangerous disease. The remainder of the essay after a brief look into the meaning of ‘creativity’ will explore whether studies have confirmed the link between bipolar disorder and creativity and if the disease confers a special ‘gift’ to those who are unfortunate to suffer from it, try to explain any associated link and then determine whether any association is tenuous or strong.

What is creativity?

Having established what bipolar is, we need to have a brief definition as to what is creativityVery simply creativity can be described as ‘a collection of behaviours/thoughts that are both adaptive/useful and novel/original’. (6). There are many different types and classifications of creativity, too numerous to relate here but for the purpose of demonstrating an association here, the majority of the studies have measured creativity subjectively as an individual attribute and has been demonstrated by occupation (7).

Evidence for an association between creativity and bipolar disorder

There is actually quite a lot of evidence for elevated rates of creativity within bipolar disorder sufferers. Reviews of biographical material have suggested that the disorder is significantly prevalent amongst samples of authors, visual artists and poets (2, 8-10).

One of the very first studies to investigate bipolar disorder and creativity was in 1949. A study of 113 German architects, writers, composers and musicians was undertaken along with relatives. The study reported an increase in the number of suicides and individuals characterised as “insane and neurotic” in the artistic group compared to the general population. The higher rates of deviance from the norm were discovered in poets (50%) and then the musicians (38%).(2).

In Ludwig’s 1994 study (9), biographical material was looked at from 1005 eminent individuals. Approximately 8.2% of those in creative professions (e.g. architecture/design, composing and performing music, writing, theatre) had reported experiences of mania. This is in comparison with the general population 1%. There are numerous other studies that show that some 10% of artists (loosely defined) had symptoms of Bipolar Disorder (11-12).

It is important to note that as well as in eminent samples of poets and musicians and other creative artisans, a strong link has been shown between creativity and bipolar disorder in the general population. Santosa et al. (2007) found people with the disorder had Baron–Welsh Art Scale scores higher than healthy controls and comparable to graduate students in creative fields (13-15). In support of this, Richards et al found bipolar patients to have greater lifetime creative accomplishment than healthy controls on the Lifetime Creativity Scales (16)

In a recent very large study of a cross sectional representative study of thirteen thousand people ordinary people in the USA, those with bipolar disorder were found more often in the most creative occupations (e.g. painting, writing, and lighting design) (17).

As well as demonstrating a strong link between those suffering from bipolar disorder and an outward manifestation of creativity, there has also been research carried out into healthy controls that suffer from hypomanic traits. Healthy samples have been found to have higher self-rated creativity, fluency, everyday creative achievement and divergent thinking (18-20)

Interestingly, there is not a directly linear relationship between the severity of bipolar disorder and creativity. On the contrary, Richards et al (1988) found that those with hypomanic traits (milder form of bipolar disorder) had higher rates of creative accomplishment than those with bipolar 1 disorder and remarkably genetically related unaffected individuals in the family had higher rates of creativity than those affected with type 1 disorder. (21-23). Andreasen in 1987 also showed that in a study of accomplished authors, more authors met the diagnostic criteria for bipolar 2 disorder than bipolar 1 (8).

This may give some indication that the severe type 1 disorder is too destructive and may interfere with accomplishment whereas the milder type 2 variety does confer some benefits to the sufferer and that a vulnerability to mania may be associated with creativity rather than mania itself. This is known as ‘The Inverted U hypothesis’. (21).

Evidence against a link between bipolar disorder and creativity

Rothenberg (2001) did some fairly rigorous research into the methodological flaws into some of the most prominent research demonstrating a link between bipolar disease and creativity (12). For example Andreason (1987) reported a 43% prevalence of bipolar disorder in a writing group compared to controls (10%) (8). However what is interesting is that the writer group were matched with controls in age, sex, and educational status but not in occupation with the controls coming predominantly from very non-artistic occupations such as ‘business men, social workers medics, lawyers and computer science students’ and the bipolar group being all being writers! Obviously matching occupations in the controls would have been vital to the design of this study. On top of this, the investigator herself carried out the interviews and there was no independent assessment of the subjects. (12)

As shown previously, in Ludwig’s 1994 study, biographical material was looked at from 1005 eminent individuals. Approximately 8.2% of those in creative professions (e.g. architecture/design, composing and performing music, writing, theatre) had reported experiences of mania. This is in comparison with the general population 1% (9) However, despite the large number of studies highlighted, material was only drawn from biographical resources. This limits the validity of the findings. Biographies may indeed provide reliable information but they are a very non-professional source. A lot of the evidence is anecdotal and whilst fascinating and irreplaceable cannot always be credited as being wholly reliable. (12) The reason for this is that in the view of self-assessment and romanticising the past, the letters and self-analysis is often blinded by bias. The reliability of letters, memoirs, journals and anecdotes can be fraught with bias and over-exaggerations in light of writing for a future generation (2) Indeed major biographers refused to write the biography of Jack Benny because he had such an ‘uninteresting, happy, boring life’!!! (12). Also, only 6% of Nobel Laureates ranging from the sciences have been written in comparison to 100% of Nobel Laureates in Literature! This shows that the biographies of famous writers are very popular especially when exaggerating eccentric behaviour and dark moods and temperaments and idealising the stereotyped melancholic poet or drunken writer. Hence they definitely cannot be relied upon as a wholly reliable source of information. (12).

Richards et al (1988) (21) showed that there was a link between hypomanic traits in an individual and creativity. However, further analysis into the designs of the study shows some very dubious definitions of creativity that are almost comical! The following example presented of the vocational category for high peak creativity:

“An entrepreneur who advanced from chemist’s apprentice to independent researcher of new products before starting a major paint manufacturing company, and whose operation surreptitiously manufactured and smuggled explosives for the Danish Resistance during World War II”

This definition of so called creativity was then matched with hypomanic symptoms but as you can see is rather dubious and seems to be clutching on straws when occupations in the creative disciplines are more commonly used in other studies! (12)

I have picked out three key studies that I used in my evidence for demonstrating a link between bipolar disorder and creativity and scrutinized the methodology. When put under the spotlight, it seems that based on these three studies, there is weak and dubious evidence for an association between bipolar disorder and creativity. However, there are other studies that have ALSO demonstrated the association and if we had more time, would allow us to evaluate and review their methodology too.

What could explain the link between bipolar disorder and creativity?

A way to investigate the apparent link between creativity and bipolar disorder is to consider personality traits (7, 24). There seems to be a significant overlap between personality traits associated with both creativity and bipolar disorder.

One of the personality traits of creative people is an ‘openess to experience’ (O). This has been found to be significantly higher in those people labelled as creative e.g. in a comparison of creative versus less creative scientists (6). This ‘openess to experience trait’ has interestingly also been associated with an increased appreciation and willingness to engage in novel ideas and experiences (25-26) and an increase in intellect (27) and correlates with an increase in creative accomplishment (28). Interestingly, there is also evidence for this trait ‘an openness to experience’ (O) to be elevated in bipolar disorder too (15, 29-31). The trait of neuroticism (N) has also been linked with more specific forms of creativity (6) and this may be due to the link between neuroticism and emotional sensitivity. (7). Furthermore, elevated levels of neuroticism are also more prevalent in those suffering from bipolar disorder compared to the general population. (32-34).

Another personality trait associated with an increase in creativity is extraversion (E). Those in the performance arts such as musicians, singers and actors are significantly shown to have higher levels of extraversion (35). Moreover, some studies have found that elevated extraversion differentiates bipolar disorder from unipolar depression (31,36-39). The strongest correlation between the trait of extraversion and bipolar disorder may be in individuals prone to mania (32) and may be more evident in bipolar disorders (40) who interestingly have the strongest links with creativity (see above).

Finally, another personality trait elevated in bipolar disorder is impulsivity and this appears to be evident even during well states (41-44). The trait of impulsivity is more marked during episodes of mania (43). Creativity has been demonstrated to be related to impulsivity too (6). Theoretically perhaps, impulsivity may induce expressiveness and the ability to produce more novel and unique work.

Thus there is a link between the traits expressed in creative people and those of the bipolar sufferer. The final section will conclude on whether I think based on all the evidence I have reviewed if there is a connection or not and then try to explain my rationale.

An association between bipolar disorder and two key components of creativity: Generativity and Consolidation

Figure 1: There is an overlap between bipolar disorder and two key elements of creativity. In the box are variables in the three areas of overlap and direction of association (45)

CONCLUSION

This essay has attempted to demonstrate the link between bipolar disorder and creativity. In summary, there are some good grounds for the widely held assumption that creativity and bipolar disorder are associated in some way. There has been a series of studies that have demonstrated that those with bipolar disorder can be highly creative. However, for future work into answering this question, the researcher should note that it is absolutely essential to look and critique the methodologies of these studies and try to look at the source of the participants, whether they are matched with the controls, what information is used to assign creativity (e.g. definitions of creativity, biographical sources etc.) and whether there are any non-biased independent experimenters taking part in the study. I selected three specific studies and exposed their methodological flaws that could most definitely have introduced an element of bias and skewed results. Despite this, there still does definitely seem to be a link between bipolar disorder and creativity that is not all due to coincidence or dubious study design. An explanation for this seems to be that traits that are elevated in creative people are also elevated in the bipolar sufferer, which would explain some of the overlap between bipolar disorder and creativity. Furthermore, those with hypomanic traits (milder form of bipolar disorder) had higher rates of creative accomplishment than those with bipolar 1 disorder suggesting that creative accomplishment is limited in severe type 1 disorder due to the destructive nature of the disease and it’s impact on life. . (22-23)

Finally, it is important to note that much of the evidence between the link between bipolar disorder and creativity stems from biographical reports and case report studies. There has not actually been a direct test in epidemiological research – a proper epidemiological study has not yet tested the link between an increased prevalence of bipolar disorder in creative populations and vica versa. I look forward to such a study design in the future.

BIBLIOGRAPHY

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31. Ren, X., &Dia, X. (2001). Personality of recovered bipolar patients in an assessment with the revised NEO Personality Inventory. Chinese Journal of Clinical Psychology, 9(1), 52-53

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33. Quilty, L. C., Sellbom, M., Tackett, J. L., &Bagby, R. M. (2009). Personality trait predictors of bipolar disorder symptoms. Psychiatry Research, 169(2), 159-163

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36. Bagby, R. M., Bindseil, K. D., Schuller, D. R., Rector, N. A., Young, L. T., Cooke, R. G., et al (1997). Relationship between the five-factor model of personality and unipolar, bipolar and schizophrenic patients. Psychiatry Research, 70,83-94.

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39. Tackett, J. L., Quilty, L. C., Sellbom, M., Rector, N. A., & Bagby, R. M. (2008). Additional evidence for a quantitative hierarchical model of mood and anxiety disorders for DSM-V: the context of personality structure. J Abnorm Psychol, 117(4), 812-825

40. Akiskal, H. S., Kilzieh, N., Maser, J. D., Clayton, P. J., Schettler, P. J., Traci Shea, M., et al. (2006). The distinct temperament profiles of bipolar I, bipolar II and unipolar patients. Journal of Affective Disorders, 92(1), 19-33

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The number of children diagnosed with Obsessive Compulsive Disorder

INTRODUCTION

Daily, the number of children diagnosed with Obsessive Compulsive Disorder (OCD) is on the increase. OCD has been shown to affect at least 2% of young people (OCF 2009). As defined by the NHS clinical guide 2005, “obsessive compulsive disorder (OCD) is characterized by the presence of either obsessions or compulsions and most commonly both” The NHS further describe an obsession as any thoughts, imagery or urge which is unwanted and intrusive, repeatedly bogging someone’s mind. Also compulsion, are behaviors or mental activities repetitive in nature which a person feels need or is driven to perform. These definitions embody the reality encompassing people suffering with OCD. The symptoms which cause significant functional impairment and distress coupled with the fact that it can either be overt and observable by others (for example, checking that a door is locked repeatedly) or covert mental act like repeating a particular phrase in ones mind tend to affect sufferers, physically, psychologically, socially and academically as would be expounded in this study. Obsessions or compulsions can negatively impact on the lives of young people within their family environment, school and with friends. Nearly all children have little worries or fears as a normal part of growing up (Pridmore, 2010). This then makes OCD in children difficult to diagnose thus removing early identification and treatment in effect leading to a more developed situation in adult hood. Research into the early diagnosis forms the crux of this study.

AIMS AND OBJECTIVES

RESEARCH AIMS

This research is aimed at scaling more light on ways of early detection of OCD in children with a view to early diagnosis and early treatment by way of research to investigate the relationship between OCD in children, adolescents and adult, thus ensuring translating the cognitive processing of threat across age groups, magnitude of symptom and how this is usually shown by sufferers with age.

Furthermore it also aims to add knowledge to what is currently known about the import of age on OCD and the best approach in detecting and treating OCD early in life.

OBJECTIVES

Interpret how OCD symptoms begin and are displayed across age groups.
Assess level of symptom in sufferers across different age groups.
Analyze critically the best practice for early detection and best approach to treatment.
Make recommendation based on research finding into OCD across varied age groups.

RESEARCH QUESTIONS

Important to this research are the following questions, which make up the body of the research:

How are the symptoms of OCD exhibited in children
What role does age play in the repression or otherwise of OCD in children
How does comparism of OCD symptoms across age groups affect current knowledge of OCD in Children
What conditions affect the repression of OCD symptoms across the test age groups
Can the success of repression across any of the age groups be used as tool to treat OCD in children

These questions would form the building blocks of the research, as the findings would formulate points of discussion.

LITERATURE REVIEW

UNDERSTANDING OCD

Previously, OCD was thought to be a rare psychiatric illness (Paige, 2007), however, research into the causes and symptoms into the condition, points out that the condition or disorder clearly characterized by cycles of obsessions and ‘rituals’ or compulsions causing extreme malfunction, fear and distress to its sufferers.

It is proposed and more likely that in the near distant future, OCD would be grouped in a field of disorders with various treatments. The proposed OC spectrum disorders might include OCD, body dysmorphic disorder (Bjornsson et al, 2010), hoarding (Pertusa et al, 2010), pathological gambling (Black et al, 2010), certain eating disorders, and autism. The current position of OCD differs in the two major diagnostic systems. OCD is perceived as an anxiety disorder In the DSM-IV, while ICD-10 lists it as an entity, which is separate from the anxiety, disorders. As stated above, proposals for the removal of OCD from the anxiety disorders and placed in an independent grouping of “OC spectrum disorders” is currently under discussion (Bartz & Hollander, 2006).

OCD is yet to be fully understood thus various theories flourish which link it to different conditions such as a connection to disgust which is a basic human emotion, which may have an evolutionary function that encourages the avoidance of contamination and disease. Husted et al, (2006), explained that functional imaging indicates that the neurocircuitry of OCD and disgust are similar conceiving OCD as a malfunction in an appraisal process. This would fit with OCD in which there are contamination concerns. However, this ideology does not tally with another theory that observes indecision as a feature of OCD and proposes the disorder is a result of disturbed decision-making strategies, which has been discussed by (Sachdev, et al, 2005). In another instance, functional imaging supports the theory that decision making involves the dorsolateral, orbitofrontal and anterior cingulate cortices (CHANGE THE WORDS) which interact with limbic structures to retain memory of emotional rewards, and the basal ganglia which is involved in behavioral execution, the same structures that appear to be involved in OCD. These are shrouded with other theories that include “not just right experiences” (Coles et al, 2010), inability to terminate improbable but grave danger concerns (Woody and Szechtman, 2010) and “an inflated sense of responsibility” (Smari et al, 2010)

OCD involves obsession that are involuntary, leading up to thoughts that are unwanted and recurring result in feelings of anxiety and many at times dread hence they are not simply cases of meticulousness or over worry. There tend to be much worse, they make the sufferer seem irrational, interfere with normal thinking and are time consuming in some cases taking up to two hours per day (Fruehling J, 1999).

They compel sufferers to make repeated attempts to try and control arising obsessive thoughts all to no avail. The ‘rituals’ performed by sufferers tend to bring temporary relief from the anxiety brought about by the thoughts as there exist a clear the relationship between most obsessions and the compulsions that follow. for example, contamination and washing. Sometimes the opposite is the case as not clear relationship can be attributed to (WHAT)for example, counting behaviors in a bid to prevent harm to others (Paige, 2007). The symptoms of OCD have been shown to grow stronger over time in cases where certain performed compulsions appear less effective in bringing relief. More elaborate measures could be taken to provide a sense of relief effectively ensuring that these become time consuming and thus interfering with everyday functioning. There have been cases of delayed indulgence so as not to appear abnormal socially, but this is nearly very difficult and the urge to perform the rituals always tends to grow. For example, students who tend to and are able to delay their compulsions while in class often tend to go to private places later on to perform set rituals during school hours. The concept of delusion cannot be attributed to sufferers of OCD, more adult sufferers often tend to recognize that such thoughts and behaviors that follow are unreasonable, however, that lack the will or ability to control them. In the face of illness or stress, OCD symptoms worsen.

The causes of OCD border around three major areas, psychological, biological and the roles of neurotransmitters.

Biologically – Studies have linked patients with childhood onset OCD to first-degree relatives, than among patients with later onsets to first-degree relatives (Starcevic, 2005). However, statistical inconsistencies have been shown to exist among twins demonstrating a higher concordance among dizygotic pairs. Upon statistical analysis further more, Grootheest et al, 2005 explained that if a dimensional approach is employed, studies amongst twins suggest heritability of obsessive compulsive symptoms. Early onset of OCD is traceable to strong genetical contributions however, this is not definitive (Pridmore, 2010).

Role of Transmitters – In another study, neurological images implicate disturbances in pathways between the cerebral cortex and thalamus as pathogenesis of obsessions while pathogenesis of compulsion along with repetitive motor acts results from abnormalities in the striatum (Insel, 1992). When comparing sufferers of OCD and other anxiety disorders, Ruda et al, (2010) observed common and distinct neural substrates as both showed a decreased level of bilateral grey matter volume in the brain. OCD like disorders caused by childhood streptococcal infections has been termed Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. It has been observed that a large percentage of children who have suffered this complication of rheumatic fever have antibodies directed against the caudate (Swedo et al, 1994).

Psychologically – OCD are shown by the symptoms explained upon earlier in this study.

OCD UK STATISTICS

Torres et al reported in 2006 that the survey of British National Psychiatric Morbidity revealed the prevalence within the general population of OCD was 1.1%. The same statistics also showed that the percentage decreased with increasing age (1.4% within 16-26years and 0.2% within 65-74 years). These statistics also revealed that the condition was slightly higher in females than males. Amongst sufferers of the condition, it has been identified that 55% suffer from only obsessions while 11% have only compulsions with 34% having both obsessions and compulsions (Pridmore, 2010). Further statistics show that 62% patients suffer from mental disorder in particular depression and anxiety, with 20% having alcohol dependence, 13% on drug dependence and 25% with a history of attempted suicide. The above statistics points to the prevalence of OCD in children who very often are ignorant of the existence of the condition and or where conscious are often very afraid to inform parents. In a 9 year survey where 142 adolescents and children where followed, Heyman et al, 2010 revealed that 41% of this population had persistent OCD, a very considerable number of those without the condition showed signs of other psychiatric conditions. This reveals that OCD is a chronic disorder amongst the younger generation with a guided prognosis.

CHILDREN LIVING WITH OCD

Childhood onset of OCD may result in children demonstrating washing; checking rituals, and preoccupation with disease, danger, and doubts inter alia (Swedo et al 1989), with an approximate 2%–3% of people (including adolescents) having OCD. Notwithstanding this may be an underestimate because many symptoms are kept secret, OCD can emerge as early as preschool. During puberty and early adulthood, the number of children who develop the disorder peaks (National Institutes of Mental Health, Pediatric Obsessive- Compulsive Disorder Research, 2006). Studies by Paige, 2007 show that one-third of adults have OCD developed from childhood. As stated earlier, children and adolescents often tend to hide the symptoms of OCD for fear of being tagged ‘crazy or weird’ this often takes its toll on the severity of the condition in sufferers later on in life. The stigma often associated with OCD come to the full understanding of most adolescents who go through extreme lengths to avoid showing the symptoms. These steps could see them seek ways to avoid situations, which tend to trigger symptoms or young sufferers become clever in devising explanations for their behaviors. Snider et al, 2000 preach that compulsive behavior begins very often gradually and the trend is inadvertently supported by unsuspecting parents at the outset, for example, in cases where children and adolescents show rituals or compulsions that tend to be developmentally appropriate such as wearing a lucky shirt to a game or lining up stuffed animals in a particular way or show healthy behavior such as appear healthy washing of hands after bathroom use, parents may not initially be concerned by such OCD symptoms thus resulting in not seeking medical treatment at the outset until behaviors have become disruptive. Study by Zohar (1999) reveal that following childhood onset, OCD has a complete remission rate of 10 to 50 percent by late adolescence and without treatment tends to become chronic affecting normal function adversely. Considerable effects on adolescents include decreased performance qualities, impaired relationships, depression, problems associated with poor academic performance and so on (Paige, 2004). Expounding further on the effect of OCD on child or adolescent school performance, OCD often at times has a considerable and significant effect on child or adolescent learning; this tends to worsen if left untreated at the earlier stages. Academic problems associated with OCD in children or adolescent include poor attendance often similar to school avoidance, perceived weird behavior as young sufferers tend to avoid situations and places that increase obsessive thoughts as they may spend more time in secret places where rituals or compulsions are performed, this often results in increased social isolation and missed learning. Other problems may include loss of concentration, which is similar to symptoms associated with Attention Deficit Disorder (ADD) as a direct result of obsessive. The consequences of such behaviors often result in victimization or bullying of students suffering from OCD while obsessive thoughts create social problems.

COMPARISON OF CHILDREN AND ADULTS LIVING WITH OCD

In a study to unearth the developmental differences in the cognitive processing of threat across children, adolescent and adult groups of individual sufferers of OCD by Farrell et al in 2006, some evidence showed that age accounted for differences in the cognitive processing of threat associated with OCD. As this study was the first to examine this relationship, it demonstrated that children suffering from OCD experienced lower anxious and intrusive thoughts in direct comparism to both adolescents and adults. Children experienced lower levels of sadness, worry, disapproval and removal strategies associated with OCD as determined by Farrell et al, (2006) when compared to adolescents and adults. The research also pointed that the intrusive and depressive thoughts experienced by children with OCD was less distressing and less difficult to resist in comparison to the other two groups. These finding where consistent with reports by Salkovskis (1985, 1989) and others (Freeston et al., 1996; Rachman, 1993). Similar results were obtained when responsibility was the factor being tested for. The results showed that children report significantly less responsibility on a self-report responsibility attitude measurement in comparison to the other two groups. This suggested effectively that by adolescent, sufferers ten to have increased attitudes regarding personal blame for harm as is also in the case of adults suffering with OCD.

RESEARCH METHODOLOGY

CONCLUSION AND RECOMMENDATION

The cognitive theory of OCD has in the past been heralded as the most widely accepted account of maintenance of the disorder in adults however; it remained to be seen if evaluation across children, adolescent and adult comparison portends any trend. To this end, research was undertaken to investigate developmental differences in symptoms displayed by OCD sufferers across the age range, the results obtained demonstrated that symptoms evinced increased across the grouping (children – adolescent – adult). This therefore suggests adoption of strategies for treatment of the condition. Importance is placed of the early discovery of the condition in an individual so as to ensure that whatever treatment is required is provided to stem increased conditions as the individual matures. Furthermore, in managing and ensuring recovery from OCD, early identification and requisite treatment remain imperative. Various strategies to manage and control the condition amongst children within the school environment and at home have to be employed. At schools, staff should be alert as to the symptoms of the disorder in any pupil and to achieve this there is need for adequate enlightenment of staff about the disorder. Advice should the sought from the school counselor as unexplained agitation in pupil, prolonged and or frequent absence from class etc could be pointers to the condition in a pupil. Also, indirect observation such as raw or bleeding hands could give required clues. Stigmatization should also be eliminated. Conclusively, parental involvement remains utmost in the management and recovery process. Some parents may require education on how to identify and support children suffering with OCD.

More research is required to fully grasp the role of responsibility, life experiences and exposures on the display and repression of OCD symptoms. This research study however, recommends a more details research into the symptoms showed by sufferers across different age groups and the roles which various factors would play.

REFERENCES

Bartz J., and Hollander E., (2006) ‘Is obsessive-compulsive disorder an anxiety disorder?’ Progress in Neuropsychopharmacology and Biological Psychiatry, vol. 30. pp. 338-352.

Bjornsson A, Didie E, Phillips K., (2010) ‘Body dysmorphic disorder’ Dialogues in Clinical

Neuroscience, vol. 12, pp. 221-232.

Coles M., Heimberg R., Frost R., and Steketee G., (2005) ‘Not just right experiences and obsessive compulsive features: experimental and self-monitoring perspectives’ Behavior

Research and Therapy, vol. 43, pp. 153-167.

Freeston, M. H., Rheaume, J., & Ladouceur, R. (1996) ‘Correcting faulty appraisals of obsessional thoughts’ Behaviour, Research and Therapy, vol. 34, pp. 433–446.

Insel T., (1995) ‘Toward a neuroanatomy of obsessive-compulsive disorder’ Archives of

General Psychiatry, vol. 49, pp. 739-744.

National Institutes of Mental Health, Pediatric Obsessive-Compulsive Disorder Research. (2006) FAQs about OCD. Retreived May 31, 2007, from http://intramural.nimh.nih.gov/pocd/ pocd-faqs.htm#FAQ-1

National Health Scheme NHS (2005) ‘Obsessive-compulsive disorder Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder’ National Institute for health and clinical excellence. www.nice.org.uk.

Obsessive Compulsive Foundation (OCF) (1999) ‘OCD in Children’

Obsessive-Compulsive Foundation. (2006) ‘What is OCD?’ Retreived June 1, 2007, from www.ocfoundation.org/what-is-ocd.html

Paige L. Z., (2004) ‘Obsessive-compulsive disorder: Information for parents and educators’ In Canter, A. S., Paige, L. Z., Roth, M. D., Romero, I., & Carroll, S. A. (Eds.), Helping children at home and school II: Handouts for families and educators.

Bethesda, MD: National Association of School Psychologists.

Pertusa A, Frost R, Mataix-Cols D., (2010) ‘When hoarding is a symptom of OCD: a case

series and implications for DSM-V. Behavioral Research and Therapy 2010; in press.

Pridmore S., (2010) ‘OCD – download of Psyciatry’ Chapter 13

Rachman S., (1993) ‘Obsessions, responsibility, and guilt. Behaviour Research and Therapy, vol. 31, pp. 149–154.

Radua J., van den Heuvel O., Surguladaze S., and Mataix-Cols D., (2010) ‘Meta-analytical; comparison of voxel-based morphometry studies in obsessive-compulsive disorder vs other anxiety disorders’ Archives of General Psychiatry, vol. 67, pp. 701-711.

Smari J, (2010) ‘Pathways to inflated responsibility beliefs, responsibility attitudes and

obsessive-compulsive symptoms: factor structure and test of mediational model’

Behavioral and Cognitive Psychotherapy, vol 38, pp. 535-544.

Snider L. A., and Swedo S. E., (2000) ‘Pediatric obsessive-compulsive disorder. The Journal of the American Medical Association, vol. 284, pp. 3104–3106.

Starcevic V., (2005) ‘Anxiety Disorders in Adults’ Oxford University Press: Oxford. 2005.

Swedo S. E., Rapoport J. L., Leonard H. L., Lenane M., and Cheslow D., (1989) ‘Obsessivecompulsive disorder in children and adolescents: Clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry, vol. 46, pp. 335–341.

Salkovskis P. M., (1985) ‘Obsessional compulsive problems: A cognitive-behavioural analysis’ Behaviour Research and Therapy, vol. 23, pp. 571–583.

Salkovskis, P. M. (1989) ‘Cognitive behavioural factors and the persistence of intrusive thoughts in obsessional problems’ Behaviour Research and Therapy, vol. 27, pp. 677–682.

Zohar A. H., (1999) ‘The epidemiology of obsessive-compulsive disorder in children and adolescents’ Child and Adolescent Psychiatry, vol. 8, pp. 445–460.

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Stephen Lawrence Case – Crime and Disorder Act 1998

Crime and Disorder Act 1998

Racism, according to the United Nations is on decline globally. The government participation in advocating and promoting racial equality within the last ten years has substantially contributed to this decline. Despite the emergence of dangerous street gangs in the UK streets, resurfacing of anti-immigrant politics in addition to media engineered hostility towards Muslims; racism on the whole is declining.

Stephen Lawrence Case

Examining the Stephen Lawrence case, if the incidence had taken place today, due to the emerging social issues within the domain of criminal justice system, the case would be differently handled. Within the growing realm of social media networks, it is becoming evident racist and religious crimes are exceedingly hurtful since they tend to injure individual identity (Thurlow 1998). Due to the increased awareness, the case could have ignited unprecedented folly across various social mediums. Since such cases take place randomly, for instance, at hotels, nightclubs, football matches or on public transport, the government has time and again attempted to implement measures which can thwart racism correlated crimes (Schuster 2003).

Due to such instances the UK government through its legislative arms passed key legislation aimed at tackling the issue of racism. Since the elements of racism are more linked to where the culprit is driven by hostility or as well hatred towards any member of the society. Hence, one of these legislations enacted to curb racism includes the Crime and Disorder Act 1998 (amended) (Thurlow 1998).

Racism on Decline in UK

Today numerous measures have been implemented which would have made the scope of policing more effective (Scott 2007). In regard to the nature of investigation carried out on the case, the latest legal provisions would have made the whole process more inclusive. For instance, Crime and Disorder Act 1998 was also amended by Protection of Freedoms Act 2012, and this came into effect as early as 25th November 2012. The act has identified new definite crimes such as stalking and equally generated racially or religiously motivated versions of these crimes.

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To demonstrate that the Stephen Lawrence case would be policed differently if it had occurred today, it would be imperative to link the happenings to a similar scenario in R v Rogers (2007) W.L.R.280, the defendant was involved in racial verbal attack on the plaintiffs, the court upheld that even if the defendant was a product of xenophobia, he had no constitutional obligation to attack others racially.

The UK government asserts that it embraces an environment where free, tolerant and democratic populace thrives. However, the balancing act of integrating individual freedom with the duty of the state must be observed, this has given rise to a more vibrant and informed society which is equally assisting the authorities to fight crimes (Schuster 2003).

In this way, it would be important to note that the issue of incompetence could not have surfaced if the case had taken place today. The problem with the previous police involvement was marred by lack of adequate skills, poor understanding of racism effects on the society, institutional racism as well as a failure of headship by leading police officers. However, today these accusations cannot be tolerated since the populace is more informed and the governments have incorporated effective measures of empowering the police force (Roediger 2010).

It would be prudent to note that the element of institutional racism including professional incompetence are no longer accepted or tolerated within the current UK police force. Today, racial essentialism is no longer accepted, with the gradual police reforms the case would be handled in a way that reflects a reformed criminal justice system as well as an inclusive investigation (Roediger 2010). The modern UK police force is surrounded by citizens who knows and understands their rights.

The influence of societal pressure which is propelling the police force to work effectively would equally compel the police to handle the case in a transparent manner. Other factors which could contribute to better policing of the case would entail the modern scientific approach to crime scene as well as procedures of conducting investigations. Likewise, the scope of police reforms which were initiated after MacPherson enquiry have contributed to better handling of the case so as to avoid public outcry in addition to negative media coverage (Schuster 2003; Scott 2007).

However, currently the police have better recording and surveillance tools which they can employ to react to such instance as Stephen Lawrence case in gathering and conducting credible investigations. On the other hand the structure as well as organization and the management of all crime investigations have been reformed and equipped with adequate facilities to match the expected degree of competence in handling racism associated cases.

The other aspect entails liaison with the affected family so as to have a deeper analysis of the affected person, regular and updated consultation with locals, and overall excision of racist language from the entire police force. Such measures would see that the case is positively and adequately handled without instances of negligence and professional ignorance (Rattansi 2007).

Another instrumental factor which could have helped the case to be policed adequately today lies in that the scope of culture, religion and racism is well understood by current British populace, and thus implementing measures which could avoid future instances of racial associated crimes. It is paramount to argue that an informed populace, reformed police force as well as government willingness to stem the vice would have played a central role in ascertaining the case was adequately handled.

Thus, if the Stephen Lawrence case had taken place today various factors could have ascertained that nothing was left for chance. Such aspects would have included: open and honest investigations, unbiased interrogation, and a dedicated police force. Such issues coupled with a knowledgeable society and media would have facilitated for a proper handling of the case.

References List

Rattansi, A., 2007. Racism: A Very Short Introduction .Oxford: Oxford University Press.

Roediger, D., 2010. The Wages of Whiteness.NY: Verso.

Schuster, L., 2003, The Use and Abuse of Political Asylum in Britain and Germany .Berlin: Frank Cass.

Scott, J W, 2007., The Politics of the Veil .NY: Princeton University Press.

Thurlow, R., 1998. Fascism in Britain: from Oswald Mosley’s Blackshirts. Oxford: IB Tauris

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Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder – Causes, Reasons and Treatment

Autism Spectrum Disorder (ASD) is defined as a developmental disability that affects people’s personalities based on how they interact with the world (Magalhaes and Almeida, 2010). However, Sparks and Dager (2012, p. 187) defines ASD as “a serious neurodevelopmental disorder that impairs one’s ability to communicate and interact with others.”

Various ASD definitions are known to be universal since they recognise it as a spectral condition (Baird et al., 2016). In his study, Umekage (2011, p. 25), indicates that ASD is a hidden disability coupled with foetal brain damage as well as impairment of neural vitro development. Characterised by interests, activities and repetitive behaviours, ASD is so complex that it varies from one case to another (Akanksha et al., 2011).

Despite various studies on the reasons, causes and treatment of ASD, there are relatively unknown rationale for its causes. Chandler and Baird (2015, p. 923) posits that people with ASD need different kinds of support since their ways of development and learning differ from every individual. The aim of this paper is to discuss the causes, reasons and treatment of ASD.

Causes of ASD

Although there are undetermined causes of ASD, scientists as well as medical practitioners believe that an amalgamation of genetic and environmental factors are the two major causes of ASD (Fitzgerald and Geschwind, 2013). To start with, the cause of ASD via genetic factors is not a simple process, but a complex of progression that involve multiple genes.

Causes of ASD – Gentics

Autism Spectrum Disorder

As indicated by Schechtman (2014, p.86) study, the rate of ASD development in identical twins as well as monozygotic is higher than rates in dizygotic and same-sex fraternal twins. This indicates that fraternal twins only share some genes, while identical twins have equal genes and therefore genes contributes much to autism. More so, Brothers as well as sisters of children with autism have high level of autism (Fitzgerald and Geschwind, 2013). From another perspective, Smith and John (2011, p. 803) in their research attributed that siblings share certain problems such as language as well as learning difficulties if one of the sibling has autism. However, it is not clear if autism is inherited as well as more general predisposition difficulties.

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Causes of ASD – Environmental Factors

Secondly, ASD can be caused by environmental factors. Environmental toxins such as mercury and thimerosoal vaccines cause autism stems (Mercer et al., 2016). More so, congenital rubella infection is one of the environmental factors that cause ASD. However, Goin-Kochel and Myers (2015, p. 172) disputes that there is any clarity environmental factors causing ASD and therefore more studies needs to be done. Rich and Isager (2012, p. 410) adds “some of the evidence proposed for environmental factors is based on case reports, which are often difficult to interpret.”

Reasons for ASD

ASD as mentioned earlier, ASD can be caused by a combination of environmental and genetic factors, however, we have reasons ASD occurs. First, Autism exists when a single gene known as fragile X syndrome (FXS) exists in the blood (Hessl and Schneider, 2013). FXS is defined as a syndrome that is coupled with autism as well as intellectual disability (Visootsak and Picker, 2015). As per Wehner and Hagerman (2011, p. 415), “Whereas ASD is a behavioural diagnosis, FXS is a medical, or more accurately, a genetic diagnosis and therefore when associated with FXS, ASD is caused by the genetic change or mutation in the Fragile X gene.”

This alters normal blood circulation, hence ASD. Secondly, individuals are affected by ASD when tuberous sclerosis, chromosome 15q and other genetic conditions subsist (Hessl and Schneider, 2013).

ASD Treatment – Medications

Core symptoms associated with ASD have no medication and cure, but we have medications that help to manage high energy levels of ASD, seizures, inability to focus as well as depression symptoms (Burrell and Borrego, 2012).

The first treatment method utilised during ASD is the early intervention service. This method improves individual’s development, especially children with ASD (Buitelaar and Wong, 2014). These services, such as vitamin therapy, auditory training, facilitated communication and physical therapy improve children talk, interaction and walk.

Early intervention services attribute the theory of mind as an explanatory ASD theory that reflects on the symptom criteria (A) of the DSM-5. As per Gallese and Goldman (2012, p. 496), the theory of mind was created by Uta Frith, Alan Leslie and Simon Baron-Cohen in 1985 to explain communication persistence as well as social interaction for people with ASD.

ASD Treatment – Behaviours and Communication

The second method used for ASD treatment is the behaviours and communication approaches. This method involves direct, organised and structural ways for people with ASD to participate in a given paediatric events and medication. As per Burrell and Borrego (2012, p. 424), applied behaviour analysis (ABA) is utilised as a treatment of ASD via behaviour and communication approach to encourage positive and discourage negative behaviours hence improving various skills needed during ASD treatment.

This is in relation to the theory of executive dysfunction which states, “Executive functions (EF) are a set of cognitive skills that are put into practice through autonomous activities.” Most of these EF skills are utilised by ASD patients to boost their flexibility, organisation, objectives and goals, anticipation as well as to be able to control their impulses (Buitelaar and Wong, 2014). Thirdly, ASD can be treated through dietary approaches.

Change in diet, such as using certain foods, mineral supplements and vitamin helps to treat certain ASD effects. However, Talalay and Zimmerman (2014) posit that although dietary approach is considered as one of the ASD treatment, there is no scientific support and recommendation.

Finally, ASD can be treated using complementary and alternative treatments. Treatments associated with complementary and alternative approaches include chelation, biological such as secretin, special diets and body-based systems (Burrell and Borrego, 2012).

Conclusion

In conclusion, the aim of this paper was to discuss the causes, reasons and treatment of the Autism Spectrum Disorder (ASD). Being a hidden disability coupled with foetal brain damage as well as impairment of neural vitro development, ASD has varied and complex behaviours hence there is unknown treatment for core symptoms.

Generally, ASD is caused by a combination of genetic and environmental factors such as genes inheritance and environmental toxins respectively. Some of the treatments for ASD as discussed included the used of the early intervention services, the behaviours and communication approaches, dietary approaches and complementary and alternative treatments. Characterised by interests, activities and repetitive behaviours, ASD is so complex that it varies from one case to another and therefore its treatments depends on an individual case.

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Bibliography

Akanksha, M., Sahil, K., Premjeet, S. and Bhawna, K. (2011) “Autism spectrum disorders(ASD).” International Journal of research in ayurveda & pharmacy, 2(5), pp.1541- 1546.

Baird, G., Simonoff, E. and Charman, T. (2016) “Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP).” The lancet, 368(9531), pp.210-215.

Burrell, L. and Borrego, J. (2012) “Parents’ Involvement in ASD Treatment: What Is Their Role?.” Cognitive and Behavioral Practice, 19(3), pp.423-432.

Buitelaar, K. and Wong, C. (2014) “Psychopharmacological prescriptions for people with autism spectrum disorder (ASD): a multinational study.” Psychopharmacology, 231(6), pp.999-1009.

Chandler, S. and Baird, G. (2015) “Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample.” Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), pp.921-929.

Fitzgerald, R. and Geschwind, D. (2013) “Autism recurrence in half siblings: strong support for genetic mechanisms of transmission in ASD.” Molecular psychiatry, 18(2), p.137-140.

Goin-Kochel, P. and Myers, B. (2015) “Congenital versus regressive onset of autism spectrum disorders: Parents’ beliefs about causes.” Focus on Autism and Other Developmental Disabilities, 20(3), pp.169-179.

Gallese, V. and Goldman, A. (2012) “Mirror neurons and the simulation theory of mind-reading.” Trends in cognitive sciences, 2(12), pp.493-501.

Hessl, D. and Schneider, A. (2013) “Fragile X Syndrome (FXS). In Encyclopedia of Autism Spectrum Disorders 79(2), pp. 1320-1324.

Magalhaes, T. and Almeida, J. (2010) “Functional impact of global rare copy number variation in autism spectrum disorder.” Nature, 466(7304), pp.368-401.

Mercer, L., Creighton, S. and Lewis, S. (2016) “Parental perspectives on the causes of an autism spectrum disorder in their children.” Journal of Genetic Counseling, 15(1), pp.41-50.

Rich, B. and Isager, T. (2012) “Mortality and causes of death in autism spectrum disorders: an update.” Autism, 12(4), pp.403-414.

Sparks, B. and Dager, S. (2012) “Brain structural abnormalities in young children with autism spectrum disorder.” Neurology, 59(2), pp.184-192.

Schechtman, M. (2014) “Scientifically unsupported therapies in the treatment of young children with autism disorders.” Psychiatric Annals, 37(9), pp. 79-92.

Smith, S. and John, W. (2011) “Col4a1 mutation causes endoplasmic reticulum stress and genetically modifiable ocular dysgenesis.” Human molecular genetics, 16(7), pp.798- 807.

Talalay, P. and Zimmerman, A. (2014) “Sulforaphane treatment of autism spectrum disorder (ASD).” Proceedings of the National Academy of Sciences, 111(43), pp.50-55.

Umekage, T. (2011) “Association of the oxytocin receptor (OXTR) gene polymorphisms with autism spectrum disorder (ASD) in the Japanese population.” Journal of human genetics, 55(3), pp. 23-32.

Visootsak, J. and Picker, J. (2015) “Advances in the treatment of fragile X syndrome.” Pediatrics, 123(1), pp.378-390.

Wehner, A. and Hagerman, R. (2011) “The behavioral phenotype in fragile X: symptoms of autism in very young children with fragile X syndrome, idiopathic autism, and otherdevelopmental disorders.” Journal of developmental & behavioral pediatrics, 22(6), pp.409-417.

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Admin – Jane
Review Date
2017-07-18
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Autism Spectrum Disorder – Causes, Reasons and Treatments
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Health Visitors’ Perceptions of their Role in Autism Spectrum Disorder

The discussion in the article mainly revolves and centers in two occurring forces particularly ASD and Health Visitors. The relationships being analyzed in these two topic areas are the progressively changing role of the health visitors towards the patient care of ASD cases. The center of study primarily is in England, United Kingdom, wherein the incident is clearly occurring and manifesting.

Health visitors are the local health works that are in charge for the surveillance of these ASD patients and not mainly on public health. However, the argument arrives in the situation since this role is being interchanged gradually. The roles of health visitors over these ASD patients are important and boundaries should be set in order to avoid inappropriate practice.

Autism Spectrum Disorder is a group disorder that manifest signs and symptoms related to the impairments of social communication and social imagination, with interest, behavior and activity constraints. Recently, there has been an increase in the prevalence rate of ASD specifically 1% of the child population or 116 per 10,000 children. The detection and surveillance of such conditions are part of the health visitor’s role.

They are trained in order to detect such occurrence and help aid for those families that confronts the disorder dilemma. Health visitors act as part of the diagnostic team, and have a role of parent supporter. However, these roles are being disregarded because the common notion that health visitor’s job only revolves in referral system.

Family-oriented type of role manifests in the health visitors and this serves as their guidelines in performing their tasks. However, a change in role towards public-oriented role is being issued. The developmental surveillance should function hence, these health visitors are requesting for trainings and developmental programs for their profession expansion.

Current Treatments in Autism: Examining Scientific Evidence and Clinical Implications

The condition of autism is under the umbrella of ASD or Autism Spectrum Disorder, and not entirely the disorder itself. Autism is characterized by the impairment in social interaction, imaginative play and language development. The etiological factor of this disorder, however, is still unclear.

Many experts suggest that it is a neurological impairment enveloping the imbalance production in neurotransmitters, particularly serotonin. Other symptoms that are associated in this disorder are the presence of poor eye contact, ritualistic behavior, self-stimulating or abusive behaviors such as hand flapping, rocking or finger licking and lastly, absence of imaginative play.

The diagnostic procedures of Autism condition lies in the behavioral manifestation of the patient. Such diagnosis can be depressive for families to receive since, Autism disorder do not have any direct cure as of now. However, there are treatment courses that are available for this type of disorder.

Behavioral treatment is one of the treatment procedures that base their concepts on learning theory and behavioral analysis. The treatment procedure specifically targets the behavior of the individual since; this is where the manifestations arise. The intervention proposed aims to modify these behavioral patterns.

Another treatment course is through educational and communication interventions. This intervention involves Project TEACCH (Treatment and Education of Autistic and Related Communication-Handicapped Children), PECS (Picture Exchange Communication System) and Greenspan’s Developmental Approach. Each treatment programs focus on developmental and cognitive functioning of the child. There are also other forms of treatment, pharmacologic, social interaction modification, and health promotion interventions.

Parent Education for Autism: Issues in Providing Services at a Distance

Autism is a condition characterized by severe cognitive impairments leading to social interaction deficit, impairment in language and absence of imaginative play. These three symptoms are the primary indicators of Autism, and this disorder is under the umbrella of ASD or Autism Spectrum Disorder. The condition of Autism is known to have idiopathic conditions or unknown etiologies hence, direct treatments are not available. Fortunately, there are therapies that reduce the manifestations of behavioral signs and symptoms. Moreover, there are pharmacological therapies that aids in the management of the disorder.

Due to the cognitive, social and behavioral deficits of these children, they are at risk of developing various threats. The article further elaborates the condition of Autism, mainly focusing on the three involved dimensions. Since autistic patients have impaired social interactions, their expression of their needs and concerns has to be sensed critically by the parents or the responsible supervisors. This kind of scenario implicates stress and other associated emotions to the family placing them under various family risk factors.

In order to resolve such case, interventions have been developed in order to aid to the indirect problems under the disorder. The basis of these interventions is the behavioral principles associated in the disorder itself. Positive behavioral support, applied behavioral analysis and critical behavioral assessment are the concepts involved in the intervention procedures.

Parents are the main access point for Autism behavioral interventions, hence; they are required to be aware of the possible treatment and intervention procedures that can be done with their patients. Parent education about the condition of Autism is stressed in order for the parents to be familiar with the behavioral conditions of their children, and be able to implement the appropriate intervention for such case.

Reference

Halpin, J., & Barbara, N. (2007, January 1). Health visitors’ perceptions of their role in autism spectrum disorder. Community Practitioner,

Harrison, J. E. (2002, April 1). Current treatments in autism: examining scientific evidence and clinical implications. Journal of Neuroscience Nursing ,

Symon, J. B. (2001, June 22). Parent Education for Autism: Issues in Providing Services at a Distance. Journal of Positive Behavior Interventions,

 

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Assignment Week 6: Sleep Deprivation, Disorders, and Drugs

Any of us if not more than some have experienced some difficulty sleeping. This can happen because of a number of things: We worry about some sort of troubling thing to come or one that has passed, or there is the all too famous insomnia, which gets the best of us from time to time. There are many times in my life that I have had trouble sleeping, whether it was from one of my three children being sick, my husband being sick, me being sick, or my mind just running from here to there which happens quite frequently.

The last time I recall that I had not gotten enough sleep would have been when my middle child had to have oral surgery. I don’t really know if it was because she was going under and she hadn’t been before, if it was the fact that my little girl was going to have surgery for the first time. I tried for several hours to fall asleep, but my mind would not stay still. I finally decided to get up and try to doze off to the television, after that did not work I made some coffee and worked on my assignment. When it was time to get up my husband and my little girl I was exhausted, as if I was at work all day.

I drove us to where we needed to go with no problem, but as we sat in the waiting room I dozed off for a few hours. As I woke it felt as if I had not slept as all, I was still exhausted. After the surgery was over and the care plan for her was set we left for home. I had got a huge cup of coffee from a convenience store, as I drank it I felt more tired. I slept for about 30 minutes on the way home, and when I got there I felt so awake. However, as I went in and settled down for a little bit, I felt more tired than I ever had.

Unfortunately though I needed to take care of my other two children, which was a very hard task at hand, even with the help of their father. I was finally able to get to sleep that night however it was a rough start to the next day. When I am unable to get to sleep I tend to sleep more than normal, and as I wake I am dragging all day and feel as I need more sleep. As I read chapter 14 Sleep, Dreaming, and Circadian Rhythms, I am better understanding of why my body reacts the way it does if I get too much sleep or not enough sleep.

When reading about the recuperation theories of sleep it made a lot of sense to me. I believe it is reasonable that we need to sleep in order for our bodies to revitalize its self, and that at some point if we were to develop a total sleep deprivation it could result in one’s death. We do know that we are in need of some sleep, however, we are still uncertain about how much sleep we much have. It is also know that many years ago people slept much more and today a person usually sleeps anywhere from seven to nine hours of sleep.

According to the circadian theories of sleep, we possess an internal timing mechanism, called a circadian clock. I fully support the belief that we are programmed or have developed a habit of sleeping at night. I believe that we choose to rest and relax not only for our health, but also because we like it so much. I believe that we experience Microsleep from time to time as well. Mucrosleeps are short periods of sleep when we shut our eyes for a few seconds either while sitting or standing. I remember while I was working I had stayed up all night, when I went to work I was completely exhausted.

I had to get something out of the walk in cooler, since it was a hot day out I sat on a crate and I dozed off for just a second, and ended up jerking awake. We do not know exactly how much sleep a human should sleep and exactly why it is necessary to need sleep. There are many types of sleep disorders, one in particular would be insomnia. There is insomnia that involves disorders of getting to sleep and staying asleep and hypersomnia, which includes disorders of sleeping too much. Causes that can influence insomnia are, for example, if a person is experiencing physical pain.

This could influence a person when falling asleep or staying asleep. There are drugs (hypnotics) that can help a person to fall and stay asleep but they have negative effects. Prescribing benzodiazepines, like valium, have side effects as a person can develop a tolerance and might have to increase the dose of that specific drug. In addition, they are also addictive. Another insomnia disorder is called sleep apnea. A person with this disorder stops breathing during sleep, which makes him or her wake up and then go right away to sleep. This disorder is very common in older or overweight people.

There is also nocturnal myoclonus (a body twitches and keeps a person awake) and restless legs syndrome. In hypersomnia, narcolepsy is the most well-known disorder. A person with this disorder complains about daytime sleepiness and falls asleep almost anywhere. Another symptom of narcolepsy is cataplexy, in which a person can lose muscle tone while being awake. This can make a person sit down suddenly or in the extreme, cause a person to drop down to the ground. Then there is sleep paralysis (unable to move when going to sleep or awakening) and hypnagogic hallucinations (dreaming while being awake).

There are drugs such as stimulants and tricyclic antidepressants that might help; however, they are very addictive and can have side effects like not wanting to eat. There is also the hormone melatonin, a natural hormone produced in the brain, which is also manufactured commercially and is associated with sleeping, but the studies are still inconsistent and debatable. (Pinel, 2011) As we know we need some sort of sleep to function normally or on a normal basis, without it we could face some pretty severe consequences. If there are problems they make medication that can help with those problems, which will allow us to sleep.

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What Is Social Anxiety Disorder?

i. Introduction Social Anxiety is a worldwide disorder that can affect anyone, no matter what ethnicity or gender they are. Social anxiety is an intense fear of social situations, especially when you are being judged or watched by others. Such as presentations, being the center of attention, public speaking, making phone calls or eating and drinking in front of others. I chose to study this topic because I find it interesting how certain social situations can cause fear in people.

Also, I show some symptoms of having social anxiety and I wish to learn more about this topic. Social anxiety disorder is also known as social phobia. It is defined as the fear of social situations that involve interaction with other people. It is the fear and anxiety of being judged and evaluated negatively by other people or behaving in a way that might cause embarrassment or ridicule. This leads to feelings of inadequacy, self-consciousness, and depression. The person with social anxiety disorder may believe that all eyes are on him/her at all times.

Social situations that provoke social anxiety are eating or drinking in front of others, being the center of attention, public speaking, presentations, talking on the telephone and asking questions. People with this disorder will do whatever it takes to avoid social situations. The symptoms of Social Anxiety Disorder are extreme self-consciousness, immense fear of being judged or watched, nausea, rapid heartbeat, sweating and trembling. ii. Overview There are many different perceptions about people with social anxiety. Statistics show that this disorder is the third largest mental disability in the world and can affect 19. million Americans at any time. Even though it can occur at any time in people’s lives, it happens most often in childhood, adolescence and adulthood. Statistics also show that women are more likely to get diagnosed with Social Anxiety, than men. People who do have it are often seen by others as just being shy, uneasy or quiet. The people who are diagnosed with social anxiety may be conflicted by these perceptions, so they may fail to seek treatment. The problem is generally unheard and they may think that they are the only ones who suffer from it.

People who do seek treatment are often misdiagnosed and labeled as “personality disorder” or “manic depressive. ” This is because social anxiety is not well understood by the general public, or medical or health care professionals. Those with the disorder usually know that their anxiety, thoughts, and fears are irrational. They realize that it is angst and terror that they are experiencing. They know that people around them are not really judging them or evaluating them. They understand that everyone is not out to degrade or embarrass them.

But despite this logical knowledge and sense, they still continue to feel and believe differently, which causes thoughts and symptoms of anxiety usually persist with no indication of going away. People with social anxiety may usually experience extreme distress in some of these situations: when they are being introduced to other people, being teased or criticized, being the center of attention or meeting important people or authoritative people. Or by being watched while doing something, announcing something in a public situation and getting embarrassed easily.

Social anxiety may be selective. A person may have an extreme fear of one occasion, such as public speaking, but be perfectly comfortable in any other situation. People with a social phobia are nervous, anxious, and afraid about many social situations. Simply attending a business meeting or going to a party can be highly nerve wracking and intimidating. Although people with social anxiety want to be social with everyone else, their anxiety about not doing well in public is strong and hinders their efforts. They freeze up when they meet new people. ii. What Causes Social Anxiety Disorder? What Are The Symptoms? Knowing the exact causes of social anxiety is still an ongoing research and there is no single known cause. However, there are environmental and psychological factors that will play a role in its development. This development of this disorder can be from a humiliating experience the patient has experienced in the past. People diagnosed with social anxiety may have developed this disorder by seeing what has happened to someone else when that person has been embarrassed.

As mentioned before, there are also emotional, physical and behavioral symptoms of social anxiety. Emotional symptoms can range from fearing that other people will notice that you’re nervous, to worrying for days or weeks prior to a social situation. Physical symptoms are nausea, sweating, rapid heartbeat, feeling faint, trembling and shaking. The behavioral symptoms are avoiding any type of social situation to an extent where it disrupts your life and hiding “behind the scenes” to escape from being noticed. iv. Treatment for Social Anxiety Disorder

Two types of treatment may be used to help patients suffering from social anxiety. A certain type of therapy can be used, cognitive-behavioral therapy, and it has proved to be effective in most cases. Medication is also useful in treatment. Antidepressant, such as MAOI’s, in contrast with CBT, is the most beneficial. Benzodiazepines like Xanax, Valium and Ativan are prescribed to people who have social anxiety to treat it. But research has shown that if the two treatments are not used together, success is only temporary.

Also, treatment must include a therapist and an active behavioral therapy group. Group therapy for social anxiety use CBT techniques includes role-playing and training of social skills. This group therapy uses acting or mock interviews to work on the social situations that will make you anxious. The most important steps in defeating social anxiety disorder is understanding, becoming aware of the problem, and committing to go through all treatments, including therapy. v. Conclusion I learned that Social Anxiety Disorder can affect millions of people at any given time.

I think I show signs of Social Anxiety Disorder because during social situations, such as presenting, I show the symptoms. I get anxious, shaky, nervous and rapid heartbeats. In my opinion, this is probably one of the worst mental disorders that someone can have, because it is so misunderstood and misdiagnosed. What makes the situation even more difficult is the fact that the disorder does not just come and go like other disorders. A person is faced with it every day of their life, every time they have to go out anywhere or are put in a situation where others are involved.

They have to deal with this all the time, until they are treated. Unfortunately, most people do not know that they have it. Without some kind of formal education, knowledge, or treatment, social anxiety continues to ruin their lives. And if they finally do try to seek help, chances are that they will not find. This is the reality for 19. 2 million Americans, but yet there is very little being done in the way of trying to help them realize that they are not just shy or introverted, they really have a problem. REFERENCES Websites: Stein MB, Stein DJ. Social anxiety disorder.

Lancet. 2008;371:1115-1125 – (http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001953/) Jaffe-Gil, Ellen, M. A. ; Smith, Melinda, M. A. -www. helpguide. org ;(http://www. helpguide. org/mental/social_anxiety_support_symptom_causes_treatment. htm) www. nimnh. nih. gove/index. shtml (http://www. nimh. nih. gov/health/publications/social-phobia-social-anxiety-disorder-always-embarrassed/what-is-social-phobia. shtml) www. wikipedia. org (http://en. wikipedia. org/wiki/Social_anxiety ) www. webmd. com (http://www. webmd. com/anxiety-panic/guide/mental-health-social-anxiety-disorder)

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Identifying Major Depressive Disorder

We, as human beings at some point would feel low, unstable and sometimes would not know how to exactly describe what we feel bout certain things. Most often it is unknown to us that we are maybe suffering from mood disorders, we become unaware of ourselves. Mood disorders are portrayed by having wide swing of emotions; it ranges from deep depression to extreme excitement, exhilaration or euphoria and agitation. There are actually two forms of mood disorder; the first one is depression and the other is bipolar respectively.

Mania is characterized by intense and or unrealistic feelings of excitement and euphoria, and depression involves feelings of extraordinary sadness and dejection. In some cases wherein mania and depression comes together it is known to be bipolar, in which a person with this disorder would have to feel extreme excitement and deep sadness simultaneously. When depression exists for the longest time it is called dysthymia. It is known to be similar with major depression but it is a long term disorder, it is mild and not an acute (Dinsmoor., December, 2002).

Symptoms of depression

The symptoms of depression can be manifested easily in a person. These symptoms are actually various and it can be easily recognized. A person with a depression would have the symptoms of having difficulty in sleeping; they do not get their sleep easily because their minds are restless and due to this they would feel stressed or fatigued. It can also be the other way around; people with depression can also be recognized if they sleep excessively.

They would also loose their appetite and would usually loose weight or they would do excessive eating and gain weight. It can also manifest in their activities; people with depression would loose their attraction in their activities that they do find pleasurable. Major depression disorder can also come with the loosing the appetite for sex or having sexual problems; it can also be accompanied by headaches. There is also the feeling of guilt, hopelessness, helplessness, worthlessness and one of the hardest manifestations is that they find concentrating on certain things too difficult (Association, 2000).

Is Katherine suffering from major depressive disorder?

Katherine has been experiencing the symptoms engaged in the mood disorder which is called major depressive disorder, in which she often wishes she were dead, she feels sad all day long and cries several times a day, she experiences disturbed sleep and, as a result, she feels fatigued all day long, she has absolutely no interest in sex or even spending time with friends, she finds it extremely difficult to concentrate at work and just does not want to be around people.

If these feelings and wide variety of undeniable changes are not induced by alcohol or any drink that would make her feel down, if they are caused by a difficulty in her functions in her work or at home and if they were not caused by great sorrow I can make a systematic statement that Katherine is really suffering from major depressive disorder. And since Katherine has more than five of the symptoms attached with major depressive disorder I can say that she is really suffering from it.

Katherine needs to be treated while she is still in the early stage of her depression or while she still can handle her situation. If she would not be immediately treated she might at some point make an attempt to kill herself or commit suicide.

Treatments for major depressive disorder

There are several treatments for a patient who has a major depressive disorder. There is psychotherapy or counseling for people who have depression disorder and there are various medications or drugs used in treating people who are afflicted with this disorder. Numbers of medicines are used in the cure of major depressive disorder, these actually falls into the category of anti-depressants and are further categorized into a more particular drug or medicine.

Among the anti-depressants are Tricyclic anti-depressants or TCA’s which can actually relief depression by increasing the neurotransmitters’ concentration in the central nervous system. Another one is the Monoamine oxidase inhibitors or MAOI’s acts as an agent in helping break down a particular neurotransmitter which would help regulate the mood of a person to become stable or normal.

The third kind of anti-depressant is the Lithium carbonate which helps in reducing the activities of the nerves in the brain; it alters the chemical balance within a particular nerve in the brain. And the last kind is the serotonin which helps in transmitting messages without interrupting the brain chemistry.

Treatment for Katherine

In the case of Katherine she can be treated by using both psychotherapy and medication. I would use the interpersonal and or behavioral therapy on her for me to know what triggered her depression. I need to have a background of her present relationships; her relationship with her family, her relationship with her current boyfriend, her relationship with her friends, her relationship with her officemates and her other relationships. And after having analyzed her relationship patterns I would focus on her current behaviors. I would be able to know what triggered her present behaviors also by her past behaviors or the things that had actually happened to her that might have contributed to her behavior now.

Aside from these two psychotherapy some activities might help in diverting Katherine’s emotions by encouraging her to try to involve her self in activities that would be pleasurable to her, like talking to a friend to release some of her emotions or going out with someone who is sensible and nice so that she can enjoy and forget about her depression. In her medication I would just give her an anti-depressant that would suit her because it might cause further complications if I would give her inappropriate medicine.

Psychotherapy and the use of medicine would result to a more improved and satisfying results rather than using therapy or counseling alone and or just by giving medications. It is really hard to know if someone is suffering from a major depression because one might not notice the symptoms right away. The most important thing is to give ones self a chance to know his or her self more.
References

Association, A. P. (2000). Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition American Psychiatric Publishing, Inc.

Dinsmoor., R. S. (Ed.) (December, 2002) Gale Encyclopedia of Medicine. Gale Group.

[Electronic Version] Retrieved March 05, 2008 from http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/mood_disorders.jsp

 

 

 

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Men and Women Eating Disorders

Modern society’s inclination to appreciate thin people has led to a significant increase in the incidence of eating disorders. While eating disorders are highly associated with women, the condition is not gender oriented and as such, can inflict both sexes. This paper discusses eating disorders that occur to both men and women.

What is an Eating Disorder?

Eating disorder is a condition where victims generally make use of food to achieve physical or emotional objective. This means that people with eating disorders may deprive themselves of food so they will become thin, or use starvation as a means to deal with unwanted feelings or emotions. Eating disorder is  popularly associated with  two conditions,  the anorexia nervosa and bulimia, both of which, can be generally defined as the extreme concern to body weight and image although such other conditions as rumination disorder and pica, which primarily occur among infants are also considered as eating disorders. Another form of eating disorder is binge eating which is most common among people who are on a diet.

Psychologist Kelly Bemis described anorexia nervosa as “a complex physical, emotional, and behavioral changes occurring in individuals who starve themselves because of an aversion to food or weight gain” (Lucas, 2004). Those who suffer from anorexia nervosa are characterized by a false perception about their body size. This perception leads to self inflicted starvation or refusal to eat and which consequently results in severe weight loss that has devastating health and mental implications. Other weight loss strategies include vomiting several times in a day, using laxatives and over exercising.

People who suffer from bulimia, on the other hand, are also characterized by the same extreme weight and image consciousness but they have a craving for food, which causes them to go for binge eating. Bulimics generally feel guilty when they overeat and to prevent themselves from gaining weight, use risky weight loss strategies similarly employed by anorexics. People inflicted with bulimia and anorexia are both characterized with feelings of depression and anxiety.

Unlike bulimia where victims overeat and purge themselves after by vomiting or using laxatives, people with binge eating conditions eat large amounts of food but do not purge themselves. They do not use laxatives nor vomit habitually but merely abstain themselves from eating or they go on a diet. A recent study conducted in Harvard Medical School showed that binge eating is now more prevalent than anorexia and bulimia (Stein, 2007).

Among the symptoms of eating disorders include extreme weight loss; starvation or refusal to eat; frequent vomiting; obsession with exercise; and depression. Eating disorder is both a physiological and psychological condition, victims of which, do not only lose weight but also suffer from other psychological conditions such as depression.

Eating Disorder among Women

The National Association of Anorexia Nervosa and Associated Disorders (ANAD) (1995) reported that ninety percent of the people who are inflicted with anorexia and bulimia are women. Eating disorder among women is reported to begin during the teen years, which when left untreated, can persist through adulthood. The onset of eating disorders among some girls are said to follow after traumatic and stressful life experiences such as leaving home or  death of a loved one.

In the case of anorexia, women are usually within the range of 90 percent of ideal body weight before they develop the illness (Blinder, 2001). Eating disorders are also most prevalent among teen-age girls. The National Women’s Health Report (1995) accounted that   girls who are at risk of developing eating disorders are highly successful individuals who have feelings of insecurity and who may resort to controlling their food intake and weight to make them feel powerful. Eating disorder among women is highly attributed to the society’s preferential treatment to slim women.

One distinct symptom of eating disorder among women is the loss of monthly menstrual cycle, which is the result of being extremely undernourished causing impairment of normal bodily functions such as that of the reproductive organs.

Eating Disorder among Men

The reason why eating disorders have been greatly associated with women is because more women suffer from the disease than men. For this reason, eating disorders, such as anorexia in  men may become under-diagnosed because most people, even anorexics, are generally unaware that eating disorders can occur to both men and women (Blinder. 2001). Eating disorders, however, are not gender biased conditions and as such, there are also cases of men suffering from eating disorders. It is, in fact,  estimated that ten percent of the eight million people in the United States who suffer from eating disorders are men (“Issues for Men”, 2006).

While symptoms, conditions and implications of eating disorder among men and women are generally almost similar, there are aspects that vary between men and women. For example, eating disorders are more likely to occur in girls who are achievers. In men, most likely sufferers are those who come from lower socioeconomic groups; those who feared competition, and those who were not successful in their academics and in their profession (Blinder. 2001).

If culture dictates that men should be big and strong, why is it that eating disorders occur in some men? According to Blinder (2001), males with eating disorders experience “sexual isolation, sexual inactivity and conflicted homosexuality”. Gays, who are also pressured in becoming physically and professionally successful,  are thus most likely victims of eating disorder.

As such, eating disorders is prevalent among male homosexuals. This, however, does not mean that heterosexual males do not develop eating disorders because they do. Male runners and jockeys, for example, who are involved in activities that necessitate low weight and who suffer from too much stress and pressure can develop eating disorders (“Issues for Men”, 2006 ). Unlike women who develop the condition because they perceive themselves to be fat, most men who develop the disease are actually overweight prior to being inflicted with the condition.

Conclusion

While eating disorders have always been associated with women, a number of men also suffer from the condition. There are general similarities in eating disorders between men and women, both sexes primarily use food to lose weight and to deal with emotions. There is however some discrepancy in the characteristics of victims; physical perception and weight prior to illness; and symptoms such that girls lose their menstrual cycles as an effect of starvation. Because the condition is highly associated with women, treatment of males with eating disorders has been difficult. Some male bulimics and anorexics do not realize they suffer from eating disorders because they are not aware that the illness can strike both men and women.

References

Adolescent and Eating Disorders. (1995, Nov. 1). National Women’s Health Report, 17, 3.

Blinder, B (2001). Anorexia in males. Retrieved March 8, 2007 from http://www.ltspeed.com/bjblinder/anmales.htm

Lucas, A. (2004). Demystifying Anorexia Nervosa: An Optimistic Guide to Understanding and Healing. New York: Oxford University Press

Stein, R. (2007, Feb 1.). Bingeing Now Seen As Most Common Eating Disorder. Washington Post, A02

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Gender Identity Disorder

Gender Identity Disorder/Gender Dysphoria Gender identity disorder (GID) or transsexualism is defined by strong, persistent feelings of identification with the opposite gender and discomfort with one’s own assigned sex. (“Psychology Today”) Due to a recent change to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, “Gender Identity Disorder” will be replaced with “Gender Dysphoria”. For the purpose of this paper those two terms will be interchangeable.

This paper will explore the symptoms that lead to a gender identity disorder diagnosis as well as the treatment process and obstacles a person with this disorder may face. It is a difficult process and is not something somebody would endure unless they truly believed they were meant to be the opposite sex. Symptoms of a person with gender dysphoria can vary from person to person but there is certain criterion that must be met in order to obtain that diagnosis from a licensed professional.

Some of the criteria in children includes; Repeated expressed desire to be the opposite sex or that they are the opposite sex, discomfort and/or disgust of own gentiles, cross-dressing for boys or masculine attire for girls, prolonged preference for cross-sex roles in play and games or fantasies of being the opposite sex, desire to only have friends of the opposite sex and belief they will grow up to be the opposite sex. The symptoms for an adult with gender dysphoria is somewhat different because they are of age and able to effectively communicate thoughts and desires.

Some of these symptoms include persistent discomfort with current sex, stated desire to be the opposite sex, frequent attempts to pass as the opposite sex, desire to get rid of gentiles, social isolation, depression and anxiety. The only way for a proper diagnosis is to be evaluated by a licensed clinical psychologist who specializes in gender identity issues. Once a diagnosis is reached what is treatment like? Treatment includes counseling, group and individual, hormone therapy, and if chosen, gender reassignment surgery. Individual, group, family, and couples counseling can ll be necessary to help not only the GID patient cope and come to terms with the person they feel they were always meant to be. There is also a network of people that surround that person that will also be affected by this diagnosis and decision. Individual therapy is suggested for the person who is gender dysphoric and mandatory if they want to take further steps in treatment (hormone therapy, reassignment surgery). Group counseling has also been found to be of great benefit. It gives the GID patient the ability to explore the diagnosis in a safe environment with peer’s similar situations.

Family counseling for family members that are involved in that person’s life, and if in a relationship couples counseling could also be a useful tool. Hormone treatment is used to enable a safe gender transition, both physical and emotional. It is usually part of a multi-stage process that can also include Real Life Experience (cross dressing), hormone therapy and gender reassignment surgery. But it must be noted that some individuals opt to stop with hormone therapy and not go on to change their anatomy permanently.

Hormone therapy is when sex hormones are administered to bring out secondary sexual characteristics. For example a male who desired to be female would be administered estrogen and a female who desired to be male would be administered testosterone to enhance sexual characteristics of the opposite sex Sex reassignment surgery, gender reassignment surgery is a procedure that changes a person’s external genital organs from those of one gender to those of the other. (Frey, 2006) A person must be deemed a transsexual with gender dysphoria before reassignment surgery is even considered.

A transsexual is a person with gender identity disorder who has overwhelming desire to change anatomic sex. (Ford-Martin, 2011) Other criteria may include recommendation by 2 mental health specialists trained in gender identity issues or sometimes a team of specialists, undergone hormone therapy successfully for at least one year, living “real life”/ cross-dressing for a minimum of a year, deemed emotionally stable and medically healthy or at least existing conditions being treated and controlled. Whatever treatment is chosen is just the beginning of the journey.

There are many ramifications a person with gender dysphoria faces; psychological, social, and religious. According to local psychologist Dr. Gerald Ramsey, Ph. D. in his book “Trans-Sexuals Candid Answers To Private Questions” he states “Transsexuals from some religious backgrounds have grown up with the admonition that homosexuality is a mortal sin, punishable by fire and brimstone. These individuals believe they are putting at risk the future of their souls – facing not just the loss of family and friends, but the ultimate judgment of God, which may include spiritual annihilation.

To confront, explore and challenge such beliefs takes incredible personal energy and faith. ” (Ramsey, 1996) As you can see a diagnosis of gender dysphoria affects all aspects of life from potential loss of friends and family to learning to interact and live as the “real you”. In this paper we discussed the symptoms of a person with gender identity disorder or gender dysphoria. We also went through the different courses of treatment related to this disorder as well as the potential obstacles encountered.

The process is life changing and isn’t something taken lightly. Bibliography Gender identity, disorder diagnosis dictionary. (2005, 10 24). Retrieved from http://www. psychologytoday. com/conditions/gender-identity-disorder Frey, R. (2006). J. Polsdorfer (Ed. ), Gale Encyclopedia of Medicine (3rd ed. ). Ford-Martin, P. (2011). L. Fundukian (Ed. ), Gale Encyclopedia of Medicine (4th ed. , Vol. 3). Ramsey, G. (1996). Tras-sexuals- candid answers to private questions. (p. 80). Freedom, CA: Crossing Press.

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Diagnosis and Treatment

For many Americans it is difficult to come to terms with any type of medical diagnosis. Some may know the warning signs and simply ignore them. Unfortunately mental disorders have plagued many people for years. Going without diagnosis and treatment can have devastating effects to themselves and their families. According to the National Institute of Mental Health “Approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder” (NIMH, 2009). These disorders come in several forms and can have many different warning signs. For some these signs or symptoms can be mild and for others the signs are immediately noticed.

“Mood disorders are characterized by disturbances in mood or prolonged emotional state sometimes referred to as affect.” (Psychological Disorders, 2010) Because everyone has their own mental capacity it can be difficult for a professional to diagnose. Some people can’t cry unless it is a highly emotional situation, others can cry at the first sign of emotional distress. While others may show anger in a stressful situation and some may feel the tendency to laugh. These are all nature human behaviors; each of these emotions can also be signs or symptoms of mood disorders. Because these signs and symptoms are so broad and are also specific to several different mood disorders they can be misdiagnosed for years.

The range of mood disorders can vary but there are significant signs and symptoms to look for. For some with mood disorders they have extreme highs and lows, meaning that they are extremely happy one minute and can be extremely sad the next. In patients with depression you may see that the “person feels overwhelmed with sadness; they may have loss of interest in activities and display other symptoms such as guilt or feelings of worthlessness.” (Psychological disorders, 2010) According to the National Institute for Mental Health “Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44” (NIMH, 2009) These patients usually have experienced the loss of happiness in everyday life. They may be your co-worker, family or friend who has issues with concentration, sleep, or has become reclusive.

Even though depression is a mood disorder in itself, there are several forms of depression. Generalized depression is the person who has become withdrawn from life; they may sleep too much or not enough. Another form of depression is clinical depression; this form is much more severe and can be deadly. Unfortunately “depressed people may be plagues by suicidal thoughts or may even attempt suicide.” (Psychological disorders, 2010) Apart of the signs and symptoms of clinical depression is that the down feel does not go away after time. Those with clinical depression stay depressed; they are unhappy and have moments of extreme depression. “Some depressions can be so intense that people become psychotic-that is, they lose touch with reality.” (Psychological disorders, 2010). This form can make people believe in a false reality. They often feel as though everyone is out to get them or that they are being subjected to inhuman activities.

Depression can be treated in many ways depending on the severity of the disease. There are many drugs out on the market today to help with the symptoms of depression. Generalized depression has become a popular trend in commercial marketing. The signs and symptoms are often discussed and the public is educated on talking to their physician if they may have any of the signs of symptoms that are listed in the commercials. Because of the frequency of these commercials more and more people have followed the trend and are speaking to their physicians about the possibility of depression. According to the CDC “approximately 15.7% more people were diagnosis with depression or related diagnosis in 2006 compared to 2005.” (CDC, 2006) Some studies may suggest that the increase in diagnosis is directly related to the public awareness brought forth by the commercial campaigns to promote new medication to treat depression.

The treatment for many forms of depression is through various forms of medication. These forms of medication are often referred to as antidepressants. The compounding for these drugs are typically neurotransmitters or inhibiters. Some help to produce or block particular chemicals in the brain that are possible causes for particular forms of depression. Counseling can also help those that are suffering the effects of depression. For some counseling may be prescribed with or without the assistance of medication. Speaking to a medical professional about the diagnosis of depression can help each patient to be individually treated for the symptoms of the depressive disorder. Even though the public has a higher level of awareness when it comes to depressive disorders it is still important to seek advice from a medical profession.

Reference

http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml

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Mental Disorder

Project In Health Submitted by: Rochel Marie Jaranilla 4th- Jade Submitted to: Ms. Amarro Health & PE Teacher A mental disorder or mental illness is a psychological pattern, potentially reflected in behavior, that is generally associated with distress or disability, and which is not considered part of normal development of a person’s culture. Mental disorders are generally defined by a combination of how a person feels, acts, thinks or perceives. This may be associated with particular regions or functions of the brain or rest of the nervous system, often in a social context.

The recognition and understanding of mental health conditions have changed over time and across cultures and there are still variations in definition, assessment and classification, although standard guideline criteria are widely used. In many cases, there appears to be a continuum between mental health and mental illness, making diagnosis complex. According to the World Health Organisation (WHO), over a third of people in most countries report problems at some time in their life which meet criteria for diagnosis of one or more of the common types of mental disorder.

The causes of mental disorders are varied and in some cases unclear, and theories may incorporate findings from a range of fields. Services are based in psychiatric hospitals or in the community, and assessments are carried out by psychiatrists, clinical psychologistsand clinical social workers, using various methods but often relying on observation and questioning. Clinical treatments are provided by various mental health professionals. Psychotherapy and psychiatric medication are two major treatment options, as are social interventions, peer support and self-help.

In a minority of cases there might be involuntary detention or involuntary treatment, where legislation allows. Stigma and discrimination can add to the suffering and disability associated with mental disorders (or with being diagnosed or judged as having a mental disorder), leading to various social movements attempting to increase understanding and challenge social exclusion. Prevention is now appearing in some mental health strategies. Conclusion

Stigma is both a proximate and a distal cause of employment inequity for people with a mental disability who experience direct discrimination because of prejudicial attitudes from employers and workmates and indirect discrimination owing to historical patterns of disadvantage, structural disincentives against competitive employment and generalized policy neglect. Against this background, modern mental health rehabilitation models and legislative philosophies, which focus on citizenship rights and full social participation, are to be welcomed.

Yet, recent findings demonstrate that the legislation remains vulnerable to the very prejudicial attitudes they are intended to abate. Research conducted during the past year continues to highlight the multiple attitudinal and structural barriers that prevent people with mental disabilities from becoming active participants in the competitive labour market. Project In Health Submitted by: Jiovanni Kim Agustino Submitted to: Ms. Amarro

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Posttraumatic stress disorder

In your opinion, is the government doing enough regarding the diagnosis/treatment of mental illness and PTDS for our returning Iraq and Afghanistan war veterans. (2-3 pages) No, I don’t believe that the U. S. Government is serving the populace in the most diligently way possible. Today which is different from the service people of even my father’s era? In his day back in 1946 WWII had just ended. Though women were on the front lines as nurses they weren’t there as a moving part of the military, flying planes, driving tanks, on board of ships to bearing a weapon.

Times are a changing! Poor grammar yes but that was the way that phrase goes. Now today also gays and Lesbians are allowed to be “Out and proud”! We were always there just now we have a voice and a Right to openly serve. We have always been in the military defending our neighbors. Now like the melting pot that holds all the different variations that can cause mental anguish that allows PTSD to rear its ugly head it seems the variations are un-limited. Now some emotions might be stirred by hatred within the units in the field wielded toward their fellow fighting commandants’.

I’d not sure but I would imagine that during Korea and Vietnam women made up maybe only a slight population of the MASH (Mobile Ambulance Surgery Hospital)Bombs bursting around them as well as our poor wounded soldiers can be added to other outward disturbances that can cause PTSD in the Medical Corps. Women who were nurses, in the Civil War, “Clara Barton”, one of the well known historic nurses that changed for the better care of our battled heroes. Stress is a killer also a side effect of PTSD, suicide. There is a story of two sisters (twins) that both were aboard the sister ship of the Titanic called the Lusitania.

The Lusitania was used as a hospital ship in WWI. It carried the wounded, the near death and in some cases the dead. Screams and the smell of the infections haunted one of the sisters to take her life by leaping to her watery death. Her sister’s courage weighed heavy upon the sister who lived till the end of the second trip home from France where the injured boarded. Upon arriving home she resigned and went about her life; unfortunately the sounds of the ship and the pain of her missing sister was I guess you might say the death of her.

Her health fell into ruins and her days were marked, she never wed and died before she was 50. According to The US Department of Veterans Affairs (Affairs, 2009), PTSD is defined as “an anxiety disorder that can occur after you have been through a traumatic event. [ (Affairs, 2009) ]A traumatic event is something horrible or scary that you see or that happens to you.

During this event, you think that your life or others’ lives are in danger. [ (Affairs, 2009) ]You may feel afraid or feel you have no control over what is happening. [ (Affairs, 2009) ]PTSD from combat is not always acknowledged by the individual suffering from it because of embarrassment, fear of being medically discharged, lack of understanding about what is happening to them, and a variety of other reasons. [ (Affairs, 2009) ]As a person suffers through this disorder without having a proper medical diagnosis or understanding, their life may become very difficult to cope with. [ (Affairs, 2009) ]

The exact rate of PTSD in women veterans is unknown. (Iowa, 2007)Studies conducted after the Gulf War concluded that female service members were more likely than their male counterparts to develop PTSD. Iowa, 2007)This is consistent with the 2 to 1 ratio of female to male PTSD sufferers in the general population. (Iowa, 2007) Women are seeking help due to both war trauma and victimization by their peers. (Iowa, 2007) Military sexual trauma is the term used by the VA to refer to a variety of sexual offenses ranging from verbal sexual harassment to assault and rape. (Iowa, 2007)

The Veterans Health Care Act of 1992 authorized new and expanded services for women veterans including outreach and counseling services for sexual trauma incurred while serving on active duty. Iowa, 2007) Treatment of PTSD in women who have served in combat is in its infancy. (Iowa, 2007)A treatment intervention known as “Prolonged Exposure Therapy (PE)” is being used by the VA along with a cognitive approach. (Iowa, 2007)PE therapy gradually exposes the client to images of the threatening experience and has the client repeatedly recount his or her traumatic (Iowa, 2007)memories.

Presently, 600 therapists are being trained in these approaches for treatment of female veterans with combat trauma. Iowa, 2007) Women’s Veterans Program Managers are now being placed at VA medical centers across the country. (Iowa, 2007)There are also programs for women who are homeless and those who are at risk of becoming homeless. (Iowa, 2007) I think that time will either be for our advantage as a country and a lesson learned allowing us to implement devices that will help our heroes as they make their journey inwardly and outwardly homeward bound. So they can sleep at night without worries of the war and the things that dominated days and nights while defending America.

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Schizotypal Personality Disorder

Psyc101 Psychological Disorders Schizotypal Personality Disorder The cluster A disorder, schizotypal personality disorder, is not to be confused with Schizophrenia. It is on the milder end of the spectrum but can still have extreme effects on one’s life and relationships. The disorder, which affects nearly 3% of the population, can be defined by several different behaviors and has many symptoms. Unlike schizophrenia, the people with this disorder can acknowledge their behavior but still may not want or seek treatment.

A person with schizotypal personality disorder will have trouble with interpersonal relationships and can display what is described as odd or unusual behavior. They are not comfortable in social settings or surrounded by groups of unknown people. Someone with this disorder will tend to be a loner especially if there are no immediate family members around. Due to a lack of social skills or feelings of inadequacy they may never marry nor have children because they cannot relate to others in a normal way.

Often characterized by odd thinking and beliefs, paranoid thoughts, distorted perception and a lack of close friends, there are other symptoms as well. One may be prone to delusions or hallucinations, be superstitious or believe they have ESP (extrasensory perception). Persons may dress in abnormal ways such as mismatched clothes or dirty clothes and may not even attend to their personal hygiene.

Individuals with this disorder feel so disconnected and distant from the rest of society that some of these symptoms arise as way for them to have something to cling to in hopes of being able related to something or someone. Therapy, including one on one, couple or group, and medication can be used to help someone with schizotypal personality disorder to function. Some of the therapies would require the person to interact and “bond” with the therapist in order to learn social skills such as trust.

A therapist may also try to teach someone with the disorder how to correctly respond to people with actions or expressions and can try to alter their paranoid ideas to improve relational connections. Medications cannot treat the disorder, however, certain ones can help alter moods or treat symptoms of anxiety and depression. Individuals with a personality disorder such as Schizotypal may have odd or eccentric behaviors and isolate themselves from others. Many symptoms of this disorder cannot be treated with drugs and with urging people may not seek therapeutic forms of treatment.

In conclusion, a person with this disorder can remain lonely and distant with little interaction with society and will never experience the joy and happiness of a “normal” life. Works Cited Mayo Clinic Staff. “Schixotypal Personality Disorder. ” MayoClinic. com. Mayo Foundation for Medical Education and Research. October 8, 2010. Web. October 8, 2012. http://www. mayoclinic. com/health/schizotypa-personality-disorder/DS00830/ Minddisorders. com. Encyclopedia of Mental Disorders. n. d. Web. October 8, 2012. http://www. minddisorders. com/Py-Z/Schizotypal-personality-disorder. html

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Major depressive disorder in children

Depression is fast becoming one of the most widespread illnesses affecting the youth today. It is often described in layman’s terms as a condition in which a certain individual feels sadder than normal, as having the case of “the blues”, or of being uncharacteristically disheartened and miserable. However, Major Depressive Disorder (MDD), also known as clinical depression, is characterized as a psychological disorder wherein an individual is rendered incapable of removing himself or herself from a persistent sense of sadness and a lessened interest in all of his or her activities.

These symptoms must persist for a period of no less than 2 weeks in order for a diagnosis of Major Depressive Disorder to be made. (Watt & Markham, 2005) Other symptoms of MDD include feelings of worthlessness, significant weight change, listlessness, thoughts of death.

Watt & Markham (2005) posit that MDD has biological factors in its etiology in children. These involve genetic make-up and hormonal imbalance. Other factors contributing to MDD include psychological and environmental factors. Psychological factors may involve functions of learned helplessness, melancholia, and depressive character traits which all contribute to the eventual self-defeating way by which the child will view the world.

Environmental factors include stressful life events such as the loss of a loved one or a child’s negative experience in one of the social roles he or she plays. Social roles in children often include those they have in their families and in school. Not being able to successfully fulfill these roles can again lead to self-defeating thoughts and to feelings of worthlessness in the child.

Psychological, environmental and biological factors all play an equal role in contributing to a child’s eventual experience of MDD. It is most likely that all these factors are at play to a certain degree in a clinically depressed child. What is clear, however, is that the foundation of MDD in the depressive child’s life is far-reaching and broad. It stems from many different aspects of the child’s persona and as such affects all these aspects in turn. All three factors must be taken into consideration.

However, because children are still in an unbalanced state of development, their psychological and biological states are still in a precarious condition. This renders Major Depressive Disorder in this age group closed to certain types of treatment for depression. Only a few types of treatment have been found to have efficacy in reducing depressive symptoms in children. And even then, these few treatments have not all been able to provide truly child-friendly ways of dealing with depression.

One of the treatments for MDD, which has received much interest from researchers, is pharmacotherapy. This involves the intake of drugs, tricylcic antidepressants (TCA’s) and selective serotonin reuptake inhibitors (SSRI’s), to suppress and decrease the symptoms of MDD. However, it has been seen that most research findings conflict in presentation of efficacy of pharmacotherapy treatment for adolescents and prepubescent children. (Milin et al, 2003)

Electroconvulsive therapy, which involves introducing an electric shock to the individual’s system, also has greater efficacy in treating MDD in adults. However, the application of this treatment on adolescents and prepubescent children proves to be problematic. (Milin et al, 2003) Numerous ethical issues must be considered before psychologists and psychiatrists can test electroconvulsive therapy on children.

One of the safest and least dangerous treatments that are applicable to clinically depressive children is psychosocial therapy. This includes Cognitive Behavioral Therapy (CBT), interpersonal therapy, and family therapy. Treatment for Major Depressive Disorder, however, may not be limited to merely one type. Combinations of the different classes of treatment can be made in order to create a greater chance of improvement and recovery for the individual. (Milin et al, 2003)

Combining CBT with antidepressant medication has shown results that prove the combination to be more effective in treating depression than simply applying one of the given treatments alone. (Rupke et al, 2006) Combining CBT with different psychosocial therapies such as family therapy, wherein the family is educated on the condition of the child, has also proven to be a much more effective treatment style. (Asarnow et al, 2002)

Personally, I would choose to administer CBT over the other therapies because it provides the most flexibility in terms of addressing specific types of depression experienced by the individual. (Asarnow et al, 2002) In treating a child with MDD, individualization is essential. The treatment style that would best fit the child’s lifestyle and personality should be chosen. The CBT sessions will be fitted to match specific aspects of the child’s depression.

The first step I would take would be to assess the child in terms of the type of depression he or she has. We would then pinpoint, together, the negative automatic thoughts he or she is prone to have. We would trace the specific situations and environments which lead him or her to this kind of negative thinking and to behavior characteristic of depression. Upon establishment of the child’s behavior patterns, goals for the CBT sessions will be set. To what extent does the child want to reduce his or her symptoms of depression? This will allow him or her to develop a sense of involvement in his or her own treatment. Having the child set his own goals gives him or her greater motivation to accomplish them.

At first the child will be asked to simply monitor himself or herself by keeping a log of his or her behavior. The log will consist of the initially pinpointed negative thoughts and behaviors that the child has chosen to change. The instances he or she has pinpointed will also be monitored and kept in the log. The first 2 weeks of data in the log will serve as the baseline. The log will be assessed by the child with my guidance after baseline is set.

He or she will be guided to acknowledge the cognitive distortions he or she makes in certain situations. These may include catastrophizing, black and white thinking, fortune telling and the like. These are maladaptive and only increase the child’s sense of misery, which is a chief characteristic of MDD. For example, if the child admits to always thinking that everything that goes wrong is his or her fault, he or she will be shown the irrational foundations of this belief. Afterwards, different ways of reacting and behaving will be conceptualized in order to replace the previous behavior and cognitions. The child will be guided to realize that external situations and individuals are outside his or her control but that the way he or she reacts, his or her perception of these events is what he or she can control.

The log will be continued in order for the child and myself to monitor his or her progress. In it, he or she will also place details of assigned homework. Homework will involve practicing the new behaviors and way of thinking we devised together. This is essential to the CBT sessions. The bulk of the therapy’s success will rely on the child’s constant practice. Coping mechanism such as relaxation techniques, meditation and the like will be taught in order to assure continued progress in the child’s treatment from depression. These coping and relaxation mechanisms will also be assigned as homework.

Later on, activities which the child previously avoided will be performed in the hopes of creating for the child a new schema. This will instill in the child a renewed self-confidence and a new self-image. Other social activities will also be pinpointed, in which the child will engage, as a means of reinforcing the positive schema he or she is gaining about himself or herself and the world. Family intervention therapy may also be an option should the child’s family want it.

References

Asarnow, J. R., Scott, C. V., & Mintz, J. (2002). A combined cognitive-behavioral family education intervention for depression in children: a treatment development study. Cognitive Therapy and Research, 26(2), 221-229

Rupke, S. J., Blecke, D., & Renfrow, M. (2006). Cognitive therapy for depression. American Family Physician, 73(1), 83-86

Walker, S., & Chow, J. (2003). Major depressive disorder in adolescence: a brief review of the recent treatment literature. Canadian Journal of Psychiatry, 48(9),600-606

Watts, S. J., & Markham, R. A. (2005). Etiology of depression in children. Journal of Instructional Psychology, 32(3), 266-670

 

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Eating Disorders (the Black Swan)

The main character Nina Sayers has a sever eating disorder. In her attempts to be the perfect ballerina, she is both anorexic and bulimic. She does not eat anything and if she does she later throws it up. For example, for breakfast she was forced to eat a grapefruit but is later shown in the bathroom throwing it up. When she gets the part in the play she worked so hard for, her mother buys a cake in celebration – only to be put to waste since Nina refuses to eat it. In the movie, she provides an example of what can happen when an eating disorder completely takes over.

She becomes so pleased with the positive feelings she feels when she looks at herself in the mirror, that she only tries to love her image more. This habit begins a downward spiral into eating less and less. In The Black Swan, Nina is portrayed as the best dancer of her company. Until some competition, Lily arrives and Nina views her as a huge threat. This causes Nina extreme stress and she develops the idea that Lily is out to get her and take her position as best dancer. Since extreme starvation of the body leads to cognitive distortions, threats are commonly amplified.

Nina feels extremely threated and like her spot as best dancer is at risk. She then feels even more of a need to have the perfect body and to be a perfect dancer. Since she does not eat enough, her brain and body do not receive appropriate amounts of nutrients. The lack of nutrients puts her in a state of high stress and her brain does not think clearly or logically. It distorts her surroundings giving her a warped image of herself when looking in the mirror. She sees herself as much larger than she actually is. She compares herself to everything and everyone around her.

Not only does her eating disorder hurt her mentally but also it physically affects other parts of her body. When feeling the urge to eat, she claws at her skin on her back where it can be covered by clothes. Nina’s fingers are also covered with bandages to conceal her skin she carelessly peals away. The thought of becoming a perfect ballerina literally begins to kill her. Although Nina never sought help, there are plenty of ways she could have. Cognitive-behavioral therapy or group therapy would both have been very helpful for her situation.

Cognitive-behavioral therapy focuses on current behavior rather than childhood or past experiences. The therapists typically address ways their patients should change the way they think and behave, assign homework, and offer strategies of how to change them for the better. Group therapy also would have been an effective way to treat Nina’s eating disorder. If she went to group therapy and saw that other people were going through the same thing as her and got better, it would have encouraged her that she could do the same.

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Language Disorders

Language development is connected to the physical maturation, cognitive development, and socialization of a person. Yet, the details of the process — the particulars of what happens physiologically, cognitively, and socially in the learning of language — are still being debated.  Language disorders are the impairment or deviant development of the normal processes in language development. These are often characterized by comprehension and/or use of spoken, written, and/or symbol system.

The disorder may involve (1) the form of language (phonologic, morphologic, and syntactic systems) (2) the content of language (semantic system), and or (3) the function of language in communication (pragmatic system) in any combination (Committee on Language, Speech, and Hearing Services in Schools of the ASHA, 1982). . The ASHA definitions suggest a classification scheme involving five subsystems or types of language: phonological (sounds), morphological (word forms), syntactical (word order and sentence structure), semantic (word and sentence meanings), and pragmatic (social use of language).

According to Hegde (1996), whatever the age of the child being assessed, it is the role of  clinicians to typically follow a set of common procedures that serve as the foundation for the assessment. The assessment procedure usually entails obtaining clinician various types of relevant data such as:

– results of visual and/or audiological evaluations;

– medical data that may be relevant;

– psychological data, including results from cognitive and intelligence testing

After that a general overview of a child’s language skills will be suggested, if there is a possible language problem and further assessment is necessary.  In determining the developmental feature of language disorders, however, these are diagnosed separately, the presence of speech or language problems that cannot be explained by an obvious medical condition. For example, linguistic deficits can be confined to expressive language or can extend to receptive abilities, although pure receptive impairment is seldom seen.

When it comes to speech output, affected children may fail to produce sounds that would be expected on the basis of age and dialect, which may be associated with difficulties in the planning and execution of the fine motor sequences that underlie speech. It is important t note that although the ideal time to begin treating children with language problems is during the preschool years, many times it is during elementary school that language problems in children become apparent as the child begins to demonstrate deficiencies in reading and writing which hinders academic progress.

For preschool children, there are two features that can be associated with language-learning disability classified to be in the morphosyntactic form. Factors like mental retardation, environmental factors, and others could be the causes of these disorders.  Characteristics associated with language problems can include the following:

Problematic syntactic skills. – Shorter instead of longer sentences, simpler instead of more complex sentences, single words or phrases in place of sentences, and a limited variety of syntactic structures.
Problematic learning of grammatic morphemes – Difficulty with comparatives and superlatives (e.g., small, smaller, smallest), omission of bound morphemes (e.g., past tense-ed, plural-s), and incorrect use of learned grammatic morphemes, including overgeneralizations (e.g., womans/women, goed/went) past the appropriate developmental point.

In school-age children or older person, morphosyntactic difficulties have been observed with the following features:

Difficulty in using complex words or sentences containing subordinate clauses and suffixes – They may have problems inflecting words using suffixes (e.g., making a plural by adding s, constructing the present progressive by adding ing).

Limited length of sentences; sentences are shorter than expected – School-age children with syntactic difficulties might leave out important grammatical markers, such as articles (a, an, the) and might have problems using pronouns correctly (e.g., say her did it instead of she did it).
On the area of disorders in features of semantics, preschool children have been observed to have the following difficulties:

Slow or delayed language onset – Delayed babbling, slower vocabulary growth rate, delayed acquisition of vocabulary, slowness in combing words into phrases and sentences, and overall slower acquisition of language milestones.

Limited amount of language output or expressive language – Limited verbal repertoire, lack of complex or longer word productions, limited amount of vocabulary produced and comprehended, and lack of abstract words in repertoire.

On the other hand, disorders of semantics in school age children and adults have been observed with these features:

Word-retrieval problems in conversational speech resulting dysfluencies such as repetitions, revisions, and false starts – For example, after hearing the word rumpus five times in the story Where the Wild Things Are, the child might still react to this word in the future as if he or she has never heard it before.

Problems with word-definition skills; possibly especially evident in defining scientific and technical words –  For example, when faced with a situation that has rumpus-like characteristics, the child would not be able to use the word to describe the situation. The individual might not be able to make sense of stories, retell them in ways that make sense to listeners, or say things to which others can attach meaning.

In the area of pragmatics, the focus is on the context and the function of the utterance. As pragmatics define the social skills of language: how, where, when, and with whom language is used, it is thus heavily dependent on culture, what is viewed as polite in one culture may be seen as weak and unassertive in another. A person with a disorder in pragmatics might not understand how to use language in social situations.

For example, the person might start a conversation with a complete stranger by saying something like “I like planes a lot, and I like to watch them” or say something offensive, such as “You’re ugly!” or say something totally not connected with the previous statement. Individuals with pragmatic language disorders may not know how to make their needs clear to others or know how to use language for practical purposes.

Thus, problems in this area originate from the previous two disorders (morphosyntactic and semantics) because the feature of this disorder rely on the goals or functions of language, the use of context to determine what form to use to achieve these goals, and the rules for carrying out cooperative conversations; all of which are rooted in the previous two.

The proper approach to these disorders demands classification, but human beings and their language are very difficult to categorize. Therefore, all classification systems still contain ambiguities, and none can account for all cases. Children or adults may have either more than one primary diagnostic category or characteristics that do not fit into any category. This is in recognition of the fact that each child represents a unique set of circumstances, so language assessment and intervention should be individualized.

 

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Multiple personality disorder

Introduction

Multiple Personality Disorder (MPD) is one of the dissociative disorders (DD). A dissociative disorder makes a person to experience a transitory adjustment of consciousness. As such, the person has a tendency of diminishing the level of awareness towards the surroundings. Thus, dissociative amnesia and fugue, and depersonalization disorder are the other types of DD. At present, the MPD has been renamed and known in investigative term as the dissociative identity disorder (DID). An MPD or DID shows at least two separate identities of individuality. This as well seizes to manage the persons’ conduct.

Richmond (1997) explained that MPD is an abnormal condition in which the personality becomes so fragmented that the various parts cannot even communicate with each other. For the reason that, the personality in MPD is different within the person. This personality can have separate memories, behavior, physical attribution and even gender (http://www.fortea.us/english/psiquitria/mutiple.htm).

Furthermore, the personality is the result of a particular problem of an individual to cope with the environment and the new personality is a mechanism created by the psyche to deal with it. The above notion of Richmond (1997) also suggest that a person develops an alters that is, the different personalities that occur to him. This is observe when the person begins to dissociate in order to create new personality as a way of avoidance to a tremendous situation.

Most of the researchers agreed to one notion, that MPD or DID has a significant factor during childhood days. It means that this identity disorder had been developed and can be traced out on past experiences that a person undergone; it can be a traumatic one or an extreme stressful events. In addition, Cherry (n.d.) stressed that this disorder occurs when a child is abused at a young age.

As a result, his personality splits into several alters to help himself handle and deal with the stress. Hence, it was argued that multiple personality is the result of coping approaches or their means of defense mechanism to keep away from a terrible scenario. Sancar (1994 – 2006) added that these created personalities are then likely to serve as mechanism for coping with situations and events dealing with one particular aspect of the traumatic experience.

According to the website (http://www.angelfire.com/nj/Dissociative), DID or MPD is often referred to as a highly creative survival techniques, because it allows an individual to endure hopeless circumstances to preserve some areas of healthy functioning. It serves as the defensive dissociation which becomes reinforced and conditioned. Evidently, dissociative escape is very effective and the patient had already mastered the alters. He may involuntarily use whenever he sense danger or trouble.  This can be concluded that MPD may arise depending on the extent of severe experience and most often referred to as defense mechanism.

Causes

More research at present explain the concept of MPD or DID. More likely, researches unified in their investigations in tracing out the origin or causes of this disorder. The cause of the disorder is as yet unknown. However, it has been argued by some researchers that the cause of MPD is due to intense stress, trauma, and even abuses. It was assumed that the on-going trauma of abuse, which happens during childhood, just when personality is developing, somehow causes alternate, distinct personalities to form.  Unlike ego, the alternate personalities can and usually do exist completely out of awareness of the main person or of each other. It is as if the alters live in isolated compartments with no communication among them.

This is most often the effect of an early awful scenario. Furthermore, a severe childhood trauma or abuses tend to create a mental split or dissociation as a defense against the traumatic situations.  In this way, they could escape the trauma of abuse, at least temporarily by creating new personalities to deal with stress. In addition, Frey (n.d.) added that the severe dissociation which characterized by DID is currently understood to result from an innate impulse to dissociate easily, repeated episodes of severe physical or sexual abuse in childhood, lack of a supportive or comforting person to counteract abusive relative(s), and the influence of other relatives with dissociative symptoms or disorder.

Moreover, based on studies women are more likely associated with MPD because they are emotional and are commonly sexually abused than men.

Some indisputable cases of DID apparently occur as a result of severe, on-going emotional, sexual, or physical abuse. We also know that DID does not seem to happen as an adult response to trauma; say for instance, men who have been tortured for years in prison apparently do not develop DID. Thus, Adult trauma, however, might bring out other personalities if the adult had developed DID in childhood. The process seem to begin only in children. This makes sense, because childhood is the time of life when personality in general develops in all of us.

Symptoms

The symptoms (FreeEssays.cc -2003) of an individual with multiple personality disorder are: lack of appropriate emotional response – that is, a person shows an awkward reaction emotionally to a particular events, for example he may project uninterested feeling to a Christmas party or low sense of empathy; memory lose – suggests of forgetting something or not knowing what they have said or done such as lost time or misplacing a thing; feeling dream like; experiencing dissociation which might include dizziness, headaches, numbness in the body; recurrent depression – which tend the person to be sad and despair; anxiety – which the  person felt panic, uneasy, uncomfortable and somehow experiencing phobias;

Substance abuse – is a typical scenario were some individuals find it as a substitute or as a defense mechanism to face their concerns, this is because they have this perception in mind that taking the substance make them feel at peace say for instance, a teenager taking marijuana to forget his family problem; eating disorder such as bulimia, anorexia or compulsive overeating– are another way of coping mechanism of a person in which he averts his attention in taking food excessively instead of facing the problem.

In other pole, a person has no appetite to take food regularly due to disturbance of the problem; for example, a girl after a break-up with her boy friend eats too much to divert her attention rather than thinking desperately or a fat lady did after six o’clock meal just to reduce weight; a man suffering stress would probably eat too much to pacify his emotional anxiety or can not eat well; sexual dysfunction – may refer or include addiction and avoidance; has low self-esteem – being not motivated, has no desire or interest to life thus the perception is frail; shame – suggest of being socially anxious or a fear of rejection or of what others might think; sleeping disturbances – which includes insomnia, nightmare and sleepwalking; mood swing – in which a person’s atmosphere changes in present setting.

Hence, Sancar (1994) added that the co-occurring symptoms and disorder that associated with DID/MPD had been consistently observed in clinical setting that MPD patients suffered such as from panic, anger, rage, sense of unreality, flashbacks, image trauma, and hyper vigilance. People diagnosed with DID also have a secondary diagnosis of posttraumatic stress disorder (PTSD).

Thus, another significant symptom of MPD is amnesia which can not be explained by ordinary forgetfulness. It is a state which a person cannot remember anything. Generally speaking, it is a condition that the stored information in the brain with his past experiences disappeared that would certainly give him a picture of a tabula raza (Latin word which means, all is blank and empty). Say for instance, a person with amnesia may loss his memory or any information about his past; he even forgot his name, where he lives, or his family and more forgotten scenario.

DID will not be determined if the symptoms will not cause any major disturbances to the person’s life or if they were due to the physiological effects of a substance such as: drugs or alcohol or a general medical condition. This implies that DID/MPD simply be notice when alters ignite in the person’s behavior thus, this is the time were symptoms arises.

Therapeutic Treatment

The treatment for a personality disorder will take considerable time. A few sessions of cognitive-behavioral treatment will likely not have much effect on deeply rooted unconscious conflicts. This will focus on overcoming all of the unhealthy psychological defense mechanisms that have been built up over a lifetime of emotional pain. This will be accomplished primarily through genuine, honest emotional encounters with the psychologist. In essence, the psychotherapeutic work all depends on the integrity of the psychotherapeutic relationship, through which new, psychologically healthy interpersonal behaviors and healthy boundaries will replace old, unhealthy defense mechanisms (Richmond; 1997-2000).

The same as the other personality disorder the MPD or DID is curable. However, it needs to be facilitated or attended with highly qualified practitioner. A thorough and intensive individual psychotherapy or talk therapy. In this case, the session of treatment for psychotherapy is a long-process. It may take a couple of months to a year or more to be concluded. However, a large percentage of people are cured with this method. In this approach, both the person and the therapist must have sense of connection or able to become closer which generate a more trustful companionship.

In addition, the other treatment modalities according to Halgins (1997) includes: medication – which some doctors will prescribe antidepressant for DID patient because their alter personalities may have anxiety or mood disorders sometimes patient that are been given medications become psychologically dependent. Hypnotherapy be considered for memory retrieval. The alters may come out and disclose the abusive childhood reminiscences, this is also used for calming and shooting the person during treatment. Is a standard method of treatment with DID patient, because it helps patient recover repressed ideas.

It is also an alternative treatment that will help the patient stay clam while pounding out the emotional stresses. Family therapy sessions may also help to end the cycle of abuse. Furthermore, this can be a support group to the client. Because people that are close to him especially his parents and siblings are his nurturing and extending support that would possibly help the patient’s fast recovery.

It is as well appropriate to consider the behavioral therapy approaching for DID in order to carry out the clients’ natural environment thus able to stress out the current problems and factors influencing them. For the fact that it can create new problem for learning in the assumption that learning can ameliorate problem behavior. Hence, the treatment for DID will last for five to seven year in adults and usually requires several different treatment methods.

BIBLIOGRAPHY

A. Book Halgin P. Richard . 1997. Abnormal Psychology: The Human Experience of Psychology Disorders. Usa: Brown and Benchmark Publishers

B. Net Sources

Sancar Feyza 1994-2006. Exploring Multiple Personality Disorder. Available: http://serendip.brynmawr.edu/bb/neuro/neuro99/web3/Sancar.html

http://www.fortea.us/english/psiquitria/mutiple.htm

http://www.angelfire.com/nj/Dissociative/

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Physical Disorders and Health Psychology

Chapter 9: Physical Disorders and Health Psychology •psychosomatic medicine- psych factors affect physical function •behavioral medicine- applied to prevention, diagnosis and treatment of medical problems •health psychology- psych factors that are important to the maintenance and promotion of health opsych and social factors: •(1) affect biological processes •(2) long-standing behavior patterns put ppl at risk for certain disorders o50% of deaths from top 10 leading causes in US can be traced to lifestyle behaviors •poor eating habits, smoking, lack of exercise, General Adaption Syndrome (GAS)- Selye oalarm- response to immediate danger or threat oresistance- mobilize coping mechanisms to respond oexhaustion- body suffers permanent damage •chronic stress may cause permanent body damage and contribute to disease •stress= physiological response to stressor •HPA Axis ohypothalamus- pituitary gland- adrenal gland oimportant for stress ocortisol= stress hormone •baboon case study odominant males have less stressful lives due to predictability + controllability olower males experience stress from bullying, higher cortisol levels osense of control important stress, anxiety, depression related osimilar underlying physiological processes oself-efficacy: sense of control and confidence that one can cope with stress or challenges •stress can lead to decreased immune system functioning oincreased rates of infectious diseases, mono, colds, flu, •Immune system oeliminates antigens- foreign maerials, bacteria, viruses, parasites o2 main parts: •humoral> B cells, antibodies neutralize antigens •cellular> T cells, destroy viral infections + cancerous processes owhite blood cells do most of the work (leukocytes) microphages= first line of defense •autoimmune disease oimmune system overactive, attacks body cells •rheumatoid arthritis- too many suppressor T cells, body subject to invasion by antigens •HIV- human immunodeficiency virus ?AIDS-related complex first: minor health problems before AIDS diagnosis w. pneumonia, cancer, dementia, wasting syndrome… ? treated w/ highly active antiretroviral therapy •reducing stress, social support, CBT help •psychoneuroimmunology (PNI) opsych influences on neurological responding implicated in immune response •Cancer psychoncology- psych influences in development of cancer otherapy can help treatment to reduce stress, improve mood, alter important health behaviors, supportive relationships •reduce cancer recurrence and dying •influence support + development of cancer o“benefit finding”- deepening spirituality, changes in life priorities, closer ties to others, enhanced sense of purpose opsych procedures important to manage stress especially w/ children who undergo surgery •Cardiovascular problems ocompromise heart, blood vessels and control mechanisms cardiovascular disease ostrokes ocerebral vascular accidents- temporary blockages of blood vessels to brain cause temporary/ permanent damage ohypertension- high blood pressure, risk factor for other heart probs •blood vessels constrict, heart works harder, pressure •essential hypertension- no verifiable physical cause •“silent killer” •blacks more at risk than whites •genetic influences •anger + hostility increase blood pressure ocoronary heart disease •heart disease in #1 cause of death in western cultures •blockage of arteries supplying blood to heart muscle chest pain •plaque •deficiency of blood to a body part •heart attack- death of heart tissue when artery clogged •stress, anxiety, anger contribute (+lack of coping skills and low social support) •myocardial stunning- heart failure as a result of severe stress oType A behavior pattern •excessive competitive drive, sense of pressured for time, impatience, high E, angry outbursts •at risk for CHD (although cultural diffs significant) oType B behavior pattern •more relaxed, less concerned about deadlines, seldom pressured, •Reserve capacity model associations among environments of low socioeconomic status, stressful experiences, psychosocial resources, emotions and cognitions> increase risk for CHD •Pain oacute- follows an injury, disappears once injury heals ochronic- begins w/ acute episode but does not go away osubjective term pain vs. pain behaviors= manifestations of exp oemotional component= suffering oseverity of pain doesn’t predict reaction b/c of psych factors •Phantom limb pain oppl who have lost an arm or leg feel excruciating pain in the missing limb •operant control of pain pain behavior under control of social consequences oie critical family members may become sympathetic •gate control theory of pain onerve impulses from painful stimuli travel to spinal column then to brain odorsal horns of spinal column= gate osmall fibers open gate, large fibers close •brain inhibits pain oendogenous opiods- naturally exist within body> endorphins oshut down pain, runner’s high after exercise, •men and women exp pain differently omen have stronger endogenous opiod systems owomen have additional pain-regulating mechanisms odiff areas more prone to pain Chronic fatigue syndrome (CFS) olack of E, fatigue, variety of aches and pains oneurasthenia- lack of nerve strength, old diagnosis oprevalent in western world and China •Pain can kill you… oincreases rate at which certain cancers metastasize ocan weaken immune system response by reducing natural killer cells opain> stress>vicious cycle •Biofeedback omake patients aware of specific physiological functions that ordinarily not be consciously aware of •heart rate, blood pressure, muscle tension in specific areas, electroencephalogram rhythms, patterns of blood flow •(1) conscious awareness (2) learn to control them oinstill sense of control over pain •progressive relaxation obecome acutely aware of tension, relax specific muscle groups •transcendental meditation ofocus attention on repeated syllable, or mantra •relaxation response- silently repeat mantra to minimize distraction by closing mind to intruding thoughts •Coping mechanisms oprescription drugs, reduced effectiveness over time odenial oimproved attitudes, realistic appraisals thru CBT •4 leading causes of death in Us oheart disease, cancer, stroke, respiratory disease AIDS prevention ocontraception ochanging high-risk behavior is only effective prevention strategy •smoking is epidemic in china omyths: tobacco is symbol of personal freedom, important for social interactions, health effects can be controlled, important to economy, •Stanford Three Community Study o1 community- assessed risk factors for CHD and smoking o2 community- media blitz on risk factors o3 community- face to face interventions, most successful at reducing CHD risk factors Chapter 10: Sexual and Gender Identity Disorders gender identity disorder- psych dissatisfaction w/ one’s biological sex, disturbance in identity •sexual dysfunction- difficult to function while having sex, ie no orgasm •paraphilia- arousal due to inappropriate objects/ individuals ophilia- strong attraction opara- abnormal •male female sex differences omen masturbate more and admit it ofemales associate sex w/ romance + intimacy rather than male physical gratification omen have diff attitude toward casual premarital sex omen show more sexual desire/arousal omen’s self-concept characterized more by power, independence, aggression owomen’s sex beliefs are more plastic/ changeable women emphasize relaitonships •sexual self schemas- core beliefs about sexuality •Cultural differences oSambia in Papua New Guinea •adolescent boys encouraged to engage in homosexual oral sex b/c semen valued… wtf •Homosexuality omight run in families, genetic component? odifferential hormone exposure in utero ogreater probably of being left handed or ambidextrous olonger ring finger than index ofraternal birth order hypothesis- each additional older brother increased odds of being gay by one third •Gender identity disorder oa persons physical gender is not consistent with persons sense of identity tapper in a body of the wrong sex otranssexualism odifferent from transvestic fetishism- sexually aroused by wearing clothing of opposite sex odifferent from intersex individuals- hermaphrodites, born with ambiguous genitalia, hormonal or physical abnormalities oautogynephilia- when gender identity disorder begins with strong sexual attraction to fantasy of oneself as a female, then progresses to becoming a woman ogenetic component suspected •gender nonconformity oboys behaving femininely or females behaving masculinely •sex reassignment surgery controversial to directly alter gender identity to match physical anatomy oin order to qualify, must live in opposite sex role for 1-2 yrs to be sure omust be stable psychologically, financially, socially ogynecomastia- growth of breasts •intersex individuals- born w/ physical charactersitics of both sexes o5 sexes: •males •females •herms •merms- more male than female but have some femal genitalia •ferms- ovaries but possess some male genitalia •Sexual dysfunction oinability to become aroused or reach orgasm o3 stages of sexual response cycle: desire, arousal, orgasm opremature ejaculation vaginismus- painful contractions in vagina during attempted penetration olifelong or acquired ogeneralized or situational odue to psych factors or medical condition •Hypoactive sexual desire disorder olittle or no interest in any type of sexual activity •sexual aversion disorder othought of sex or brief casual touch may evoke fear, panic or disgust •male erectile disorder and female sexual arousal disorder oproblem is not desire, problem is physically becoming aroused •inhibited orgasm oinability to achieve orgasm despite adequate desire and arousal (common in women) ofemale orgasmic disorder- difficulty reaching orgasm retarded ejaculation- cumming delayed oretrograde ejaculation- shoot back into bladder rather than forward •premature ejaculation- more common, 20% of males •sexual pain disorders odesire, arousal, orgasm present opain so severe that behavior disrupted odyspareunia- no medical reason found for pain •vaginismus- pelvic muscles in outer third of vagina involuntarily spasm oripping, burning, tearing sensations during sex •Assessing Sexual behavior o(1) interviews- and questionnaires o(2) thorough medical eval- rule out medical conditions o(3) psychophysiological assessment penile strain gauge- picks up changes as penis expands •vaginal photoplethysmograph- measures light reflected from vaginal walls •Causes of sexual disorders obiological contributions •nuerological diseases •diabetes •arterial insufficiency- constricted arteries •venous leakage- blood flows out too quickly for a good boner •prescription drugs ?anti-hypertensive medications for high blood pressure ?antidepressants ?SSRIs mess w/ arousal and desire •elicit drugs- cocaine •cigarettes opsych contributions •anxiety- can increase or decrease desire •distraction men who are dysfunctional report less sexual arousal •inducing positive or negative mood directly affects arousal •performance anxiety, 3 parts: ?arousal, cognitive processes, negative affect •erotophobia- negative cognitive set about sexuality, viewed as negative or threating ? learned early in childhood from families, religious authorities ? early sexual trauma, rape victims •script theory- we all operate by following “scripts” that reflect social and cultural expectations and guide our behavior •sexual myths/ misperceptions •Treatment for sexual dysfunction education is very effective, dispel myths and ignorance about sexual response cycle otherapy, increase communication b/t dysfunctional partners osensate focus and nondemand pleasuring- exploring and enjoying each others bodies thru touching, kissing, hugging, massaging •1st phase no genitals or boobs •2nd phase genitals but no sex or orgasm •3rd sex once aroused osqueeze technique- squeezing tip of penis to reduce arousal and gain control over ejaculation omasturbation training and porn! omedical treatments •oral medication (Viagra) •injection of vasoactive substances directly into the penis? •surgery •vacuum device therapy •Paraphilia if exists, individuals normally exhibit multiple paraphillic patterns oassociated w/ deficiencies in consensual adult sexual arousal, social skills, sexual fantasies •frotteurism orubbing against someone in a crowded public place until point of ejaculation •festishism operson sexually attracted to nonliving objects o(1) inanimate object o(2) source of specific tactile stimulation… rubber o(3) body part… foot •voyeurism obeing aroused by observing unsuspecting individuals undressing or naked •exhibitionism osexual gratification from exposing genitals to strangers orisk + anxiety can increase arousal oassociated w/ lower levels of edu transvestic fetishism osexual arousal from cross-dressing •sexual sadism oinflicting pain or humiliation •sexual masochism osuffering pain or humiliation •hypoxiphilia- oself strangulation to reduce flow of oxygen to brain to enhance orgasm •pedophilia osexual attraction to kids oincest when own family •Psychological treatment ocovert sensitization- carried out in imagination of patient, associate sexually arousing images w/ reasons why behavior is harmful or dangerous •orgasmic reconditioning opatients instructed to masturbate to usual fantasies but substitute more desirable ones just before ejaculation •Drug treatments “chemical castration”- eliminates sexual desire + fantasy by greatly reducing testosterone levels ocyproterone acetate + medroxyprogesterone ouseful for dangerous sexual offenders who do not respond to alternative treatmens Chapter 11: Substance-related and Impulse-control disorders •impulse control disorders- inability to resist acting on a drive or temptation osteal, gamble, set fires, pull out hair •polysubstance abuse- using multiple substances •substance use oingestion of psychoactive substances in moderate amounts that does not impair social, educational or occupational functioning •intoxication- getting high or drunk oimpairs judgment, mood changes, lowered motor ability •substance abuse ohow much ingested is problematic •addiction- substance dependence ophysiologically dependent on the drug requires increasing amounts to experience same effect (tolerance) onegative physical response when substance no longer ingested (withdrawal) oNicotine is arguably most addictive drug in the world, more so than meth! •5 substance categories o(1) depressants- sedation + relaxation… alcohol o(2) stimulants- active + alert… caffeine o(3) opiates- analgesia + euphoria… morphine o(4) hallucinogens- alter sensory perception… weed, LSD (5) other drugs- don’t fit neatly into categories… steroids •Depressants odecrease central nervous system activity, reduce levels of physiological arousal omost likely to produce dependence, tolerance, withdrawal oalcohol •reduces inhibition, motor coordination, reaction time, judgement •esophagus>stomach>small intestines>bloodstream>heart (+other major organs)> liver •influences GABA receptors –anxiety •influences glutamate system- excitatory, memory, blackouts •withdrawal delirium- frightening hallucinations, body tremors •liver disease, pancreatitis, cardiovascular disorders, brain damage •dementia- loss of intellectual abilities Wernicke-Korsakoff syndrome- loss of muscle coordination, confusion, unintelligible speech •fetal alcohol syndrome- when pregnant mothers drink, fetal growth retardation, behavior problems, learning difficulties, physical signs •alcohol dehydrogenase- enzyme that breaks down alcohol •3 million ppl dependent in US ostages of alcoholism •pre alcoholic- drinking occasionally, few consequences •prodromal stage- drinking heavily, outward signs of a problem •crucial stage- loss of control, binges •chronic stage- primary daily activities involve drinking odrinking at early age is predictive of later abuse alcohol linked to violent behavior oBarbiturates •sedatives, help ppl sleep •highly addictive •overdosing> suicide •influence GABA obenzodiazepines •reduce anxiety •highly prescribed in US •alcohol amplifies effect oStimulants •most commonly used psychoactive drugs in US •amphetamine use disorders ?reduce appetite ?narcolepsy, ADHD, Ritalin ?stimulants illegally abused by college students… no shit •crystal meth •MDMA- ecstasy ococaine use disorders •alertness, euphoria, increase blood pressure + pulse, insomnia, loss of appetite •paranoia, heart probs nicotine use disroders •withdrawal- depression, insomnia, irritability, anxiety, increased appetite •more prone to depression •Opioids oopiate natural chemicals in opium poppy have narcotic effect o“downers” •Hallucinogens ochange sensory perception osight, sound, feelings, taste, smell omarijuana oLSD •Other drugs oSpecial K osteroids oPCP •Family and genetic influence •neurobiological influence opleasure pathway in brain mediates experience of reward odopamine- pleasure oGABA- inhibitory NT •Psych dimensions opositive reinforcement negative reinforcement- use drugs to cope/escape from bad feelings and difficult life circumstances oopponent-process theory- an increase in positive feelings will be followed shortly by an increase in negative feelings and vice versa •cognitive factors oplacebo effect oexpectancy theory •social dimensions opeer pressure omarketing omoral weakness model of chemical dependence- drug use is seen as a failure of self-control in the face of temptation odisease model of dependence- drug dependence cause by an underlying physiological disorder •cultural factors oacculturation- adapt to new culture omachismo •neuroplasticity brains tendency to reorganize itself by forming new neural connections ocontinued use of substance…. decreased desire for nondrug experiences •Treatment obiological •agonist substitution- take a safe drug that has a chemical makeup similar to the addictive drug ? methadone instead of heroin ?cross-tolerance: they act on same NTs •substitution ?nicotine gum instead of cigs •antagonist drugs- block or counteract effects of psychoactive drugs •aversive treatment- prescribe drugs that make ingesting abused substance extremely unpleasant opsychosocial •therapy •inpatient facilities •alcoholics anonymous- 12 steps •controlled use- controversial covert sensitization- negative associations by imagining unpleasant scenes •contingency management- decide on reinforces that will reward certain behaviors •community reinforcement approach •motivational interviewing- empathetic and optimistic counseling •CBT •relapse prevention •Impulse control disorders ointermittent explosive disorder- episodes where act on aggressive impulses •serious assaults or destruction of property •influenced by NT levels okleptomania •recurrent failure to resist urge to steal things not needed for personal use or monetary value •high comorbidity with mood disorders opyromania •irresistible urge to set fires pathological gambling otrichotillomania •pulling out ones hair from anywhere on body oothers •compulsive shopping-oniomania •skin picking •self mutilation •computer addiction Chapter 12: Personality Disorders •personality disorders- enduring patterns of thinking about ones environment and self that are exhibited in a wide range of social and personal contexts oinflexible, maladaptive and cause significant impairment or distress ohigh comorbidity •Axis I= current disorder •Axis II= chronic problem •5 Factor model oextroversion- talkative + assertive vs passive and reserved oagree-ableness- kind trusting vs hostile selfish conscientiousness- organized thorough, reliable oneuroticism- even tempered vs nervousness moody oopenness to experience- imaginative curious •Cluster A: odd or eccentric oparanoid oschizoid oschizotypal •Cluster B: dramatic, emotional, erratic oantisocial (m)- irresponsible, reckless behavior oborderline (f) ohistrionic (f)- excessive emotionality and attention seeking onarcissistic •Cluster C: fearful, anxious oavoidant odependent oobsessive compulsive •Biases ocriterion gender bias- criteria biased oassessment gender bias- assessment measures biased

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Impact of Mental Health Disorders in Childhood and Adolescence

Among the stated objectives of the Healthy People 2010, a national, multi-stakeholder program that aims to improve the over-all health of the American people through health promotion and disease prevention is to expand treatment services for mental health disorders. In particular, the program is aimed at “increasing the proportion of children with mental health problems who receive treatment” by enhancing the support network of affected children and their families and improving their access to mental health and other social services.

The inclusion of mental health disorders as a priority public health issue that needs to be addressed stems from the acknowledgement of the gravity of the social and economic costs of mental health problems to families and communities. More importantly, the inclusion of mental health as a national health priority reflects a significant shift in attitude in public health policy.

Indeed, mental health disorders have affected a significant portion of the American population for a long time. Estimates from the United States Department of Health and Human Services reveal that mental health problems affect 20 percent of the population annually. Likewise, the risk of developing mental health disorders cuts across age, ethnicity, gender, education, and socio-economic status, making children almost as vulnerable as older people to mental health problems.

It is estimated, for instance, that 20 percent of children and adolescents within the 9 to 17 age group are likely to exhibit symptoms of mental health disturbances such as major depression, schizophrenia, and anxiety disorders; with 5 percent of the cases being severe and debilitating to children’s normal growth and development. (USDHHS (a), 2000)

Clearly, the impact of mental health disorders on children and adolescents’ well-being is grave. Children and adolescents with mental, behavioral, and emotional disorders usually perform poorly in school and are more vulnerable to alcohol and drug addiction. As in adults, mental health disorders also increase the risk of children and adolescents towards violent and aggressive behavior and suicide. In the 1999 alone, the suicide rate among children and adolescents was as high as 2.6 percent. (USDHHS (b), 2000)

Unfortunately, mental health disorders have been poorly understood which usually deprives those affected of access to necessary treatment and services. It is worth noting, for instance, that only 27 percent of children and adolescents afflicted with mental health disorders avail of treatments, most of them receiving help mainly from in-school facilities and services. (USDHHS (b), 2000) Prevailing health policies have largely ignored the fact that mental health problems usually begin during childhood and adolescence and may have a lifelong impact on affected children. In the same manner, the public and social costs of mental health disorders have been largely ignored or underrecognized.

On the other hand, mental health disorders have been shown to have a tremendous impact on public and private health spending, amounting to $69 Billion in diagnosis and treatment expenses. (USDHHS (b), 2000) Majority of these costs were shouldered by public funds while the remainder were paid for through private spending. The figures could be higher when the indirect costs of mental health illness on productivity, damages to property, criminal justice and litigation, and insurance claims are accounted for.

Likewise, mental health disorders also place a tremendous strain on the economic lives of families and communities. A study done by Busch and Barry (2007) aimed at determining the impact of childhood mental disorders on the financial well-being of families with afflicted children reveals that the impaired functioning of children with mental disturbances affects parents’ work productivity and caring for or arranging for the care of the child often leads to lost family income in terms of lost work hours. (p. 1090) The researchers contend that caring for children with mental health disorders are as costly as caring with children with other chronic illnesses. (p. 1088)

Busch and Barry’s study was conducted by analyzing the responses of respondents to the National Survey of Children with Special Health Care Needs (NS-CSHCN) to compare the effects of children’s mental health disorders on the family’s economy to the economic impact on the family of children requiring special health care needs. (p. 1089)

To this end, the researchers utilized propensity-score matching and logistic regression in controlling for differences between children with mental health disorders and the general population sample. Results of study supported their contention that caring for children with mental health disorders was a cause of financial burden especially for those who were privately insured. (p. 1089) Results of the study also showed that caring for a child with mental health disorder severely limited the labor-market participation of parents, increased the time they spent caring for or arranging for childcare, and consequently reduced the time parents spent on other activities. (p. 1091)

Thus, the authors encourage the implementation of programs and policies aimed at supporting the families of children with mental health disorders to alleviate the adverse economic outcomes brought about by heavy costs incurred from intensive and extensive child care and treatment requirements. (p. 1095) Such programs could include the elimination of mental health restrictions in private insurance policies that prevent or reduce children’s access to mental health services and treatment that increases the risk of prolonged and degenerative disability. Another suggestion made by the authors is extending financial assistance to families caring for children with mental disorders that would help defray some of the costs involved in the medical care of such children. (p. 1094)

It is clear that the social and economic impact of mental health disorders should be a great concern for the nursing community. Nurses, who are at the frontline of health service delivery, play an important role in health promotion and disease prevention. As a critical health workforce, nurses’ support in the implementation of mental health programs is crucial in meeting health objectives and achieving positive health outcomes. Nurses have the ability to contribute to the promotion of mental health through a renewed focus on patient-centered care that takes into account the holistic dimensions of health and places emphasis on early detection and diagnosis of mental health problems.

Nurses are an important part of the support network of families and communities with respect to the provision of information and other forms of resources. Given that mental health disorders are preventable and treatable diseases, the ability of nurses to provide a timely referral for treatment services and intervention for children and adolescents who exhibit the symptoms of mental, behavioral, and emotional disturbance would be a significant factor in improving the health and lives of children and adolescents. A significant improvement in the detection of mental health disorders, for instance, can be achieved with adequate attention on the part of nurses on the cognitive, emotional, and psychological aspects of their patients.

Therefore, the nursing community, as an important part of the health workforce, must be conscious of the prevalence of mental health disorders and be sufficiently informed about their role in the prevention and treatment of these problems. This way, nurses will be able to provide the needed support to reduce the economic and social costs of mental health-related diseases. Nurses will also be fully prepared to meet the exacting challenge of improving the health and quality of life of the individuals they serve.

Works Cited:

Busch, Susan H. & Colleen L. Barry (2007). Mental health disorders in childhood: Assessing the burden on families. Health Affairs, 26(4): 1088-1095.

United States Department of Health and Human Services (a) (2000). Healthy People 2010: Leading Health Indicators. Retrieved 21 April 2008 from the Healthy People 2010 website: https://www.healthypeople.gov/Document/html/uih/uih_bw/uih_4.htm#mentalhealth

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Impairing Behavior Disorder

Each year, the U. S. Department of Education reports the percentage of school aged children receiving special education for learning disabilities in public schools. Impairing behavior disorders occur in approximately 3%-5% of school aged children. Attention Deficit Disorder (ADD) is one common disability in students. ADD is a neurological disorder that causes inattentiveness and impulsiveness. Inattentiveness means not concentrating or paying attention. Incomplete assignments the child brings home and the appearance of their papers is a good indicator that they rushed through the work without regard for quality (Umansky, Smalley, 1994).

Inattentive students often seem to be paying attention as they sit quietly and stare directly at the instructor. Yet, during this time, their thoughts have drifted off from around them. Impulsiveness is acting without thinking (Peacock, 2002). Rapid decisions made without reflecting on the consequences. A child will act quickly on an idea that comes to mind without considering that they were in the middle of doing something else that should be finished first (Barkley, 2005). Behavioral areas include the ways teachers and children cope and react.

These reactions can be divided into flexible reactions, which do not include any thought processes about consequences, and consequential responses, which include some processing before action. It is rare to find school professionals these days who have not heard of Attention Deficit Disorder. Fortunately, there are larger numbers of teachers who are willing to listen to the concerns and make accommodations for children with ADD. Informal outline speaker will use to speak from. I. Inattentiveness means not concentrating or paying attention.

A. Rapid decisions B. Act quickly C. Thought processes D. No consequences II. Impulsiveness is acting without thinking A. Not Thinking B. Never finish C. Processing D. Flexible reactions The above is how your informal outline will look. This is the document you will speak from. This document must be typed. No typing is required if using an index card. However, you must speak from an informal outline. Remember, the informal outline main points are complete sentences and sub points are key words and phrases.

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Abnormal Psychology: Abuse, Addiction, & Disorders

Psychological Disorder Analysis ABNORMAL PSYCHOLOGY: ABUSE, ADDICTION, & DISORDERS Psy 270 Jalisa Cooper February 4, 2012 Final paper Psychological Disorder Analysis Psychological disorders can be very debilitating for those who suffer from them. Psychological disorders affect a person’s ability to function normally in their daily lives. In regards to the case study of Nicole the patient Nicole is a 40-year-old Hispanic female who comes to the mental health clinical complaining of trouble sleeping, feeling “jumpy” all of the time, and experiencing an inability to concentrate.

These symptoms are causing problems for her at work, where she is a finance manager. Though the information in regards to Nicole is very limited and difficult to analyze, however the symptoms suggest that Nicole may be suffering from Post-traumatic Stress Disorder. Post-traumatic stress disorder can be difficult to diagnose and the symptoms are often unrecognizable. Posttraumatic stress disorder is an anxiety disorder which can develop from having experienced a terrifying event or ordeal in which grave physical harm occurred or was threatened.

Like many anxiety disorder they may cause jumpy and sleepless behavior depending on the anxiety disorder the individual may have. Traumatic disorders can be triggered by stress or any other event that may cause the individual to develop anxiety related symptoms. A traumatic event might be military combat experience, violent personal attacks, or even car accidents. Post-traumatic disorders can be triggered by something in their past that be generated from something major or insignificant.

While Nicole’s profile within the case study does not state the existence of a traumatic event throughout her past or present life, however I can only assume that she many have experienced something in her past that may have been triggered by stress at work or another aspect in her life. It is common for the individual to withhold this information as it may be extremely difficult for them to relive the event because it may be too traumatic.

Victims that may have experienced an event such as rape or car accident resulting in death or severe injuries may not experience symptoms at the moment of the event however they may develop symptoms shortly or later after the event once it is triggered by stress or other traumatic events. Being that the case study did not present a in depth history on Nicole I would attempt to gather information form the patient such as “Have you experienced a traumatic event recently or in your past? ” This would be to gather information about the patient to that I can pin point the origin of what is causing her symptoms.

The case study regarding Nicole mentions that she is a 40-year old woman that is suffering from a great deal of symptoms. According to the Demographics of “Faces of Abnormal Psychology Interactive: for Post-traumatic stress disorder”, middle age adults are more adversely affected than older and younger adults. In addition she is a Hispanic woman meaning for whatever disorder it is important to take into consideration her culture in treating her conditions. The DSM-IV states one of the criteria of Post-traumatic stress disorder is increased levels of arousal including insomnia, irritability, and hyper vigilance. People with these disorders may feel overly alert, be easily startled, develop sleep problems, and have trouble concentrating” (Comer, 2005). When suffering from PTSD and individual may begin to display symptoms of avoidance of any stimuli that is in anyway related or associated with the traumatic event. These methods many even include avoidance of thoughts, feelings and activities associated with are resemble the event. As stated in the case study Nicole mentioned that she is having complications with getting to sleep or in general getting the significant amount of sleep needed to maintain her energy level throughout the day.

Through her lack of sleep she is experiencing difficulty concentrating at her work facility, where her position requires a focused mind and attentiveness. She also experiences the feeling of being jumpy frequently throughout the day which relates to being easily startled or paranoid due to a past experience in relation to her current stress levels. She may have experienced something in her past that is being stimulated by her events she participate in during the day causing her to flash back to that moment and relive this event.

It is common for individuals that suffer from post-traumatic stress disorder to experience a sequence of involuntary flashbacks through thoughts and even dreams, which may also be an additional reason for Nicole’s lack of rest during the night. She may be involuntarily reliving her traumatic experience due to stress in her life preventing her to obtain the proper rest that she needs to function at work. The case study failed to explain her social life and the relationships she may have with others thus it does explain her detachment to her work assignments and her lack of focus to stay on task.

Post-traumatic stress disorder symptoms reflect emotional detachment from friends and family causing them to be unable to express loving feelings for them. Post- traumatic stress disorder individuals become hyper-vigilant which could cause them to become chronically un-alert to the things and events around them rendering them unresponsive. Which is another symptom that Nicole the case study patient displays throughout her explanation of her working abilities, she displays a lack of concentration to the tasks at hand and jumpy feeling all the time.

Those that suffer from this disorder may often become startled easily and suffer from difficulty of sleeplessness. Those individuals with PTSD often develop other disorder such as depression; substance related disorders as well as anxiety disorders. Meaning those that suffer from severe Post-traumatic stress disorders may often result to substance abuse and may of their symptoms may be influenced by the usage of these substances causing their condition to seem more extreme.

As well as depression and anxiety disorders can in addition contribute to the symptoms PTSD raising the impact of each symptom to a higher level depending on the severity of each disorder. Many times individuals are misdiagnosed because of the commonality of symptoms between disorders. Studies have shown that 60% of adult men today have experience a traumatic even, whereas 51% of adult women have experience a traumatic event at least once in their life. It is common for many individuals that experience traumatic events sometime throughout their life to not be affected by these events.

Of 50% of American that experience a traumatic event of any kind, only approximately 8% of them eventually experience Post-traumatic stress disorder symptoms later in life. It is suggested that each event is different in their own way as well as has different impacts on each individual. There are factors that predict ones vulnerability of Post-traumatic stress disorder which would revolve around the nature of the event the individual experienced. The DSM-IV states the severity of the traumatic event in one of the leading factors that help predict whether an individual may be susceptible to later suffer from Post-traumatic stress disorder.

The severe traumatic events that are more likely to induce PTSD are the events that are prolonged traumas that often affect ones family or self directly. Secondly the more likely trauma suffer that was experiencing pre-existing anxiety symptoms long before the severe traumatic event occurred is more likely to later develop Post- traumatic stress disorder symptoms. This is because the individual has already reached a point in their life that cause them to become worrisome making them unable to handle the pressures of a traumatic event of severe magnitude without having and episodes.

These individuals are unstable to cope with whatever change this event has brought on causing them to develop additional anxiety disorders. Those individuals that have a history of mental illness are way more likely to experience PTSD symptoms. Third the individuals coping techniques play a large role in ones predictability of developing symptoms of PTSD. Traumatic events can take a toll on anyone and any magnitude of the event however ones predictability of developing PTSD is based on ones ability to cope with the tragic event.

The individuals that lack the ability to move past the event often fall victim to this disorder. Those that dwell on the details of the event are at higher risk as well as those who refuse to discuss the events at all cost. Some events such as witness to death, accidents resulting in death and disastrous events could cause one to reframe communicating and expressing their feelings about the events. By reframing from acknowledging such event has occurred I could cause a mental break. Finally support is an important factor when it comes to dealing with traumatic events much like any other disorder.

Those that have a lack of support from friends, family, counseling or event therapy tend to be more susceptible to the developing the symptoms of PTSD. The lack of a support network is does not allow the individual to express their problems to someone that can understand or relate. And sufferer of a post-traumatic event needs to be able to reflect and vent some other emotions to someone close. They have to be a be to feel the support and encouragement of loved ones to keep them motivated to work through whatever they are experiencing.

There have been a set of therapies to design to address this disorder to properly treat the symptoms. The three primary goals in theory are reducing the individual’s fear of provoking stimuli. This means that therapy will assist the individual in reducing the fear or unwillingness to address and confront activities and thoughts that trigger the traumatic event. Secondly, assisting the patient in modifying counterproductive thoughts, and lastly reducing stress are method used in therapy to assist the patient progress pass this event.

The method of be reducing the individual’s fear of provoking stimuli are done through systematic desensitization, which is when an individual unlearns their fear thus reversing the classical conditioning process and eliminating the cause of them requiring the fear initially. The first phase is relaxation training of each muscle in the body while allowing the patient to then trained to calm themselves. The second phase is list of fear provoking stimuli descending from least threating and uncomfortable to more threating fears.

The third phase us the desensitization phase where the patient is slightly provoke to introduce those thoughts or stimuli while remaining calm. It is often done through imagined stimuli and then they may introduce actual stimuli to the patient. In addition to this method therapist may use cognitive techniques which challenge ones irrational beliefs and unhealthy thoughts. Reference Comer, R. J. (2005). Fundamentals of abnormal psychology (4th ed. ). New York: Worth. Fundamentals of Abnormal Psychology

Faces of Abnormal Psychology Interactive application at the McGraw Hill Higher Education Web site: http://www. mhhe. com/socscience/psychology/faces/http://www. mhhe. com/socscience/psychology/faces/# Melinda Smith, M. A. , and Jeanne Segal, Ph. D. Post-traumatic Stress Disorder (PTSD): SYMPTOMS, TREATMENT, AND SELF-HELP, (2011), Retrieved February 4, 2012, http://www. helpguide. org/mental/post_traumatic_stress_disorder_symptoms_treatment. htm Resources: Appendix A, Fundamentals of Abnormal Psychology, and the Faces of Abnormal Psychology Interactive application at the McGraw Hill Higher Education Web

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A Brazilian Fashion Model’s Death Due to Eating Disorder

For Ana Carolina Reston Marcan was from kleinsaf been her dream to be supermodel, this dream became reality. At 21, in 2006, she made the headlines around the world. Not for her modeling career, but for her painful death, attributed to “complications due to anorexia. Jundiai town, Sao Paulo, Brazil. A brown-haired teenage girl walks on to the stage at the local beauty contest. Below, her parents, wedged at the front of a cheering audience, clap enthusiastically as a judge slips a green and white sash over their daughter’s head and pronounces her the Queen of Jundiai, 1999.

Her mother wasn’t surprised: ‘The other girls were podgy and had bottoms,’ she said later. ‘She won because she was slim and elegant. ‘ It doesn’t seem an earth-shattering achievement. But for 13-year-old Ana Carolina Reston Marcan it was one step nearer her dream of becoming a supermodel. It would take Reston (who dropped Marcan from her professional name) seven years to ‘arrive’, by which time she would be working as far afield as Hong Kong and Japan, for designers as well known as Giorgio Armani and Dior.

But it was on 14 November last year that she finally crossed over from being a successful catwalk model to appearing on the cover of every magazine and newspaper in Brazil, and making headlines around the globe. Not for her modelling, but for her agonising death, attributed to ‘complications arising from anorexia’. In a year in which both ‘skinny chic’ (wearing oversized clothes on tiny body frames) and the American size 00 (an emaciated UK size two, or a waist the same as a typical seven-year-old’s) was the height of fashion in celebrity-land, Reston’s demise seems all the more poignant.

She was also the second model to die from an eating disorder during 2006. In August, at a fashion show in Uruguay, 22-year-old Luisel Ramos suffered a heart attack thought to be the result of anorexia. Although anorexia isn’t the preserve of the fashion industry, it’s hardly surprising that Reston’s death has shone a spotlight on the way the business treats its models, and more significantly, on how destructive our current perception of female beauty can be. Reston’s short life began in Pitangueiras private hospital in Jundiai on 29 May 1985.

She was born into a comfortable, middle-class family; her father, Narciso Marcan, worked for a German multinational while her mother, Miriam Reston, sold jewellery. They were neither desperately poor nor offensively rich and lived in a small but elegant bungalow on the outskirts of town. From an early age Reston wanted to be a model, partly in order to provide her family with a better life. It’s not clear why she felt such responsibility, but in the early Nineties her father was diagnosed with both Alzheimer’s and Parkinson’s disease and was later made redundant.

Even before then, though, her mother remembers the young Reston spiriting bras and high heels from her closet and pirouetting around the house in them, asking people to take her photograph. Then one day in 1999, on the school bus home, she spotted a sign announcing a beauty contest for the Queen of Jundiai. She leapt off and signed herself up. A few weeks later she took her mother on an all expenses-paid luxury trip to Rio – her prize for winning the competition. When they returned, a fashion agent offered to introduce her to Ford, one of Brazil’s top modelling agencies, for a fee of ? 100. The family accepted.

Reston’s career took off almost immediately and it soon became apparent that she had her eye on the big prize – becoming a supermodel, like fellow Brazilian Gisele. Reston’s friends thought that for the more glamorous catwalk and editorial modelling she was, at just over 5ft 6in, too short. But she wouldn’t be put off; she altered her height on her publicity shots and claimed she was just over 5ft 7in. And she seemed to get away with it. In July 2003, after four successful years at Ford, she signed to Elite, one of the biggest agencies in Brazil, a move which catapulted her from teenage wannabe to serious model.

Still Reston wanted to work abroad, and in January 2004 she finally made her first trip overseas. She was sent to Guangzhou, a Chinese city not far from Hong Kong, for three months. But although no one can pin an exact date on when she began to suffer from anorexia, one former booker, who refuses to be named, believes that it was here things started to unravel for the then 18-year-old. Reston, like so many other teenage models, travelled unaccompanied by either a personal friend or family member, someone who could help her negotiate a way through the lonely castings, where personal criticism came as standard. She arrived in China,’ explains a booker, ‘and the guys looked at her and said, “You’re fat. ” She took this very personally. ‘ Her unhappiness was evident in the letters she sent home. In one to her mother, Reston describes arriving in ‘that big place’. She goes on: ‘I [felt] so small, the city so big. I didn’t understand anything… It didn’t go right. I failed. ‘ Her confidence was being destroyed. Back in Brazil, Reston’s descent into anorexia (which ultimately resulted in her shrinking from 8st to 6st) became all too obvious.

When Laura Ancona, a journalist at the Brazilian fashion magazine Quem, befriended Reston towards the end of 2004, she sensed immediately that something was wrong. Reston, she says, only ever drank fruit juice, and after her death was found to have survived on a diet of apples and tomatoes. As Ancona recalls: ‘She said, “I can’t eat any more. ” She told me she tried to eat but felt like vomiting. She knew she had a problem, but didn’t know what she was suffering from. I think I was the first person to explain it to her – I knew she was anorexic, because someone in my family had suffered in the same way. According to Ancona, Reston’s condition was common knowledge. ‘Everyone knew she was ill,’ she says. ‘The other girls, the agencies, everyone. Don’t believe it when they say they didn’t. ‘ Reston’s aunt, Mirtes Reston, who plans to present a petition to the government demanding steps to monitor the modelling industry, is more direct. ‘These girls are white slaves,’ she says. ‘We want models to have rights. At the moment they are given no pension, no support… They just take the person away from their family and abandon them far away. ‘

In his private clinic in Jardins, a leafy, upmarket neighbourhood of Sao Paulo, psychologist Dr Marco Antonio De Tommaso, who voluntarily runs a fortnightly drop-in clinic at two of the city’s largest modelling agencies, Elite and L’Equipe, is preparing some notes on eating disorders. Tommaso has spent 11 years working with models and given consultations to nearly 2,000 of them, including some of the country’s most famous faces. He also treated Reston. Tommaso’s take on the fashion industry, and what he calls the ‘dictatorship of beauty’, is bleak.

He regards Reston’s experience as typical, citing in particular the way in which ‘new faces’ are parachuted into the most demanding and adult of worlds when they are unable to cope. ‘They experience lots of changes all at the same time,’ says Tommaso. ‘They move city, they move state, they start living alone, and the work is very demanding. Everything happens very quickly, and it is all so unpredictable. ‘ There are no official studies to prove the link between the fashion industry and eating disorders, but many experts point to a clear correlation between the two.

In a letter from 40 doctors at the Eating Disorders Service and Research Unit at King’s College London to the British Fashion Council last October, Professor Janet Treasure wrote: ‘There is no doubt there is cause and effect here. The fashion industry showcases models with extreme body shapes, and this is undoubtedly one of the factors leading to young girls developing disorders. ‘ This is borne out by Tommaso’s experience. ‘If someone is just a tiny bit bigger than the industry demands,’ he says, ‘they are treated as if they were morbidly obese.

This encourages a pattern of beauty that is absolutely unreal. ‘ Such pressures, he continues, lead many such women to build up what he calls ‘an arsenal of anorexia’: special diets, prescription and illegal drugs, starving themselves. He remembers one young model even using pills for fighting intestinal worms in order to lose weight. Journalist Laura Ancona is not surprised: ‘I’ve lost count of how many times I’ve seen models vomiting in the toilets [at fashion events], or sniffing cocaine, or 13-year-old girls fainting because they’re not eating properly. Anorexia is obviously not an illness exclusive to the fashion industry, or Brazil. According to the Norwich-based Eating Disorders Association, between one and two per cent of young adult women worldwide suffer from the eating disorder and most, like Reston, are 15-25 years old. It kills somewhere between 13 and 20 per cent of its victims. It’s not known exactly what causes anorexia, but Tommaso asserts that, for young models at least, professional demands can be a ‘very strong factor’. There are other pressures, too.

As Tommaso points out: ‘Often, low-income families begin to see their offspring as the chicken that lays gold eggs and expect them to support the entire household. The models, in turn, begin to push themselves harder and harder, placing greater demands on their bodies in the hope they will earn more money. ‘ Certainly Reston faced problems at home. The family’s life savings had been stolen in 2002 and because they only had her sick father’s pension of around ? 250 a month to live on, Miriam Reston looked increasingly to her daughter’s income. She was my crutch,’ she explains, sitting in the breakfast room of her sister’s pousada, or guesthouse. By 2004, the 18-year-old Reston was supporting her entire family. And despite her experiences in China, she continued to dream of travelling the world modelling, in order to earn more money to help her mother build a new house. In August 2005 Reston called her employers at the Elite fashion agency and told them she was leaving – she had received an offer from an agent to work in Mexico.

They urged her to stay, arguing that the Mexican modelling market required voluptuous girls, whereas Reston was now an increasingly skinny model. ‘She wasn’t listening to anyone any more,’ says her former booker. In Mexico things went from bad to worse. On her second day there Reston emailed home that she was sharing an apartment with 17 other models and was very unhappy. Other Brazilian models who bumped into an increasingly miserable-looking Reston at castings began to worry about her emotional state. One of them, Cynthia, left a note for her: ‘Girlie, we’re very worried about you.

Please come out with us or stay at home and eat something – eat whatever you want, OK? ‘ Eventually, Reston became so unhappy that Lica Kohlrausch, the owner of L’Equipe, was persuaded by some of Reston’s concerned friends and colleagues to pay for her to fly back to Brazil. ‘We brought Ana back after she did some work for Giorgio Armani and a representative rang me to say she was too thin,’ Kohlrausch told the press after Reston’s death. ‘It worried me and I acted immediately, but I didn’t see any physical signs of anorexia when she came back. On her return, Reston went to work in Japan for three months. When she came home again, in late 2005, she was barely recognisable – gaunt and colourless. As Miriam Reston recalls, ‘I looked at her and said, “My daughter, what have they done to you? ” I wish these people could see what they have done to her. She didn’t deserve this. ‘ Now seriously worried about her health, Reston’s family sent her to stay with an uncle on the Sao Paulo coast. He, too, knew that something was very wrong. On a note dated 19 January 2006, he set out a daily routine for Reston to follow as part of her recuperation.

It read: 1 Wake up, pray. 2 Strong, positive thoughts. 3 Pray. 4 Always feed yourself. 5 Pray. Despite the family’s intervention, Reston continued eating less and less, and work opportunities began to ebb away. By the middle of last year, her career as a model had virtually ground to a halt. Instead, to try and make ends meet, she was handing out fliers advertising nightclubs in Sao Paulo, earning just over ? 10 a night. But there was some comfort – she fell in love with a 19-year-old model from Sao Paulo, called Bruno Setti. I didn’t know what love was until you kissed me,’ she wrote to him, just over a month before her death. ‘Thank you for giving me the hugs that make me secure and the conversations that comfort me. ‘ On Friday 29 September, Dr Tommaso sat waiting in a room at L’Equipe, with a list of six models he was due to see that afternoon. Reston was booked in for her second appointment. But as the minutes ticked by, Tommaso got the feeling it would be another no-show. ‘I thought it was a shame,’ he sighs. ‘The agency contacted her and she said she’d forgotten.

Maybe it was true, maybe it was the anorexia. We can’t be sure. ‘ In Jundiai, meanwhile, Reston complained to her mother that members of the agency were pestering her to see a doctor. ‘She told me they were going mad [saying she was ill],’ recalls her mother. ‘Everyone was telling her she was ill… But, like all these girls, she denied it was a problem. ‘ But her mother was pretty sure by then that Reston’s health problems needed to be addressed sooner rather than later. And then suddenly, it was too late. At home on Sunday 22 October, Reston began to complain of a pain in her kidneys.

Miriam Reston didn’t know it, but for the last couple of months her daughter had been taking a cocktail of potent prescription drugs, for pain relief and slimming. Reston was admitted to the Samaritano Hospital in Sao Paulo and two days later, on 25 October, she was moved to the Hospital Municipal dos Servidores Publicos, where almost immediately she was admitted to the intensive care unit, where she spent her last 21 days. Her demise was agonising, a plastic tube inserted down her throat, unable to tell anyone how she felt, although the tears in her eyes must have made that pretty obvious.

Patches of her once long brown hair had fallen out, too. Her death certificate, for which relatives paid around 50p, cites her time of death as 7. 10am and lists the cause of death as ‘multiple organ failure, septicaemia, urinary infection’. Coldly it adds: ‘Leaves no children. Leaves no property. Leaves no will. ‘ Within hours of her death Ana Carolina Reston Marcan was famous across the world. Her death made her a martyr in Brazil – her image was splashed across the front pages of virtually every newspaper and magazine, and across the international media.

Jundiai’s teenage beauty queen had become the emaciated model who had starved herself to death. Debate raged. There was an outpouring of emotion from other anorexic girls who saw in Reston a piece of themselves; and, simultaneously, a bitter rebuke from pro-anorexia communities, whose members see anorexia as a lifestyle choice. Reston’s boyfriend requested her page on the popular Brazilian blog site Orkut be deleted after her death because it was targeted by anorexia supporters posting offensive comments.

Critics of the fashion industry, on the other hand, held her up as an example of how it was destroying the lives of young, would-be models, and in the weeks that followed, the deaths of two further Brazilian girls in similar circumstances, one a fashion student, brought further calls for the regulation of this notoriously mysterious business. Already, changes seem to be taking place. Following Uruguayan model Luisel Ramos’s death, models with a body mass index (BMI) of less than 18 – classified as underweight by the World Health Organisation (between 18. and 25 is considered healthy) – were banned in September from Madrid Fashion Week. In the wake of Reston’s death, Brazilian models now require medical certificates in order to take part in catwalk events. The Italian fashion organisation Camera Della Moda Italiana is also considering introducing measures to prevent any catwalk models at risk appearing at Milan Fashion Week in February. More recently, the British Fashion Council, which organises London Fashion Week, has prepared similar guidelines that it will eventually send to all designers and modelling agencies.

It is late afternoon and in the cobbled centre of Pirapora do Bom Jesus, Miriam Reston Marcan pulls up the shutters of her new jewellery shop – recently named ‘Ana Carolina Metals’ – and goes inside. Weeping, she picks up a letter written by her daughter shortly before her death, but which was never sent. ‘”If I could, I’d like to go back to being four, clinging on to you as if I were still in your womb, so that nobody could harm me,”‘ it reads, in curly, teenage handwriting. “But God wanted my life to change. “‘ Reston sighs. ‘I didn’t know what my daughter had could kill, but I knew it had to be treated. But my daughter rejected me, she said she was OK. ‘ She stares up at a portrait of Ana hung at the back of the shop – part of an advertising campaign which has now become a sort of shrine to her deceased daughter. ‘Do you know what I think at night time? ‘ she asks. ‘I think that she’s in the ground and the ants are eating her. I don’t know how I’m

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Obsessive Compulsive Disorder

Introduction

Throughout history, our conceptualization of obsessive compulsive disorder (OCD) has been changing alongside changes in the way we have viewed the world. With the dawning of the Renaissance in Western Europe, religious explanations based on demonic possession were superseded by a more humanistic understanding. By the early seventeenth century, the obsessions that drove Shakespeare’s Lady Macbeth to suicide were recognized to be a product of her guilty mind, for which there was no medical cure.

Obsessions and compulsions were first described in the medical literature of the early nineteenth century. They were viewed as an unusual expression of melancholia. By the beginning of the twentieth century, with the development of psychoanalysis, the focus shifted onto psychological explanations based on unconscious conflicts, but this did not provide a useful strategy for treatment. The subsequent application of learning theory to OCD led to the development of effective behavioural treatments in the 1960s and 1970s.

Compared with the pace of these historical developments, modern understanding of OCD has expanded with dramatic speed. The development of effective medical treatments of OCD has revolutionized the outlook for sufferers and propelled OCD to the forefront of scientific attention. With the growth of research into the epidemiology, psychopharmacology, neurobiology, neuropsychology and genetics of OCD, reviewed throughout this publication, the emphasis has once again swung back toward a medical model. As we enter the twenty-first century, we now recognize OCD as a common, treatable form of major mental disorder.

After the pioneering epidemiological catchment area (ECA) studies carried out by the National Institute of Mental Health in the early 1980s reported that the prevalence of OCD was substantially higher than expected, (Robins, Holzer, & Weissman, 1984) repeated population studies using similar methods have demonstrated a lifetime prevalence of 2-3% worldwide (Weissman, Bland & Canino, 1994).  Taiwan and India were the only exceptions, with rates below 1%. If these estimates are accurate, then OCD affects more than 50 million people in the world today. The prevalence does not appear to be influenced by socioeconomic status, educational achievement, or ethnicity. The disorder is more common than schizophrenia, and about half as common as depression. Yet the illness remains largely under-recognized, and the psychosocial and economic costs to society from untreated OCD are high (Hollander, & Wong, 1998).  It is not surprising that the World Health Organization has now recognized OCD as a public health priority.

While there is little doubt that the ‘hidden epidemic’ of OCD exists, the actual prevalence of clinically relevant disorder has been called into question. In the ECA studies lay interviewers were trained to make DSM-III diagnoses using the Diagnostic Interview Schedule (DIS). However, clinical reappraisal of DIS-positive cases resulted in less than 25% continuing to meet the criteria for OCD (Nelson & Rice, 1997).One explanation is that the rates of illness reported in the original ECA studies may have been exaggerated. Alternatively, the findings may reflect variability in the severity of the disorder over time.

Obsessive compulsive disorder is more common in women, although the differences are not as obvious as in depression or other anxiety disorders. An average female to male ratio of 1.5:1.0 is accepted for the community at large, although the ratio appears roughly equal in the adolescent population, reflecting perhaps the earlier onset in boys. In particularly in males, having obsessions and compulsions or magical thinking, poor social adjustment, and an early chronic course, predicted a worse outcome.

A more recent 5-year prospective follow-up study of 100 OCD patients showed that in spite of the introduction of modern treatments, outcomes were similar to Skoog and Skoog’s cohort, with only 20% reaching full remission of their OCD, 50% showing partial remission, and the remainder unchanged or worse over 5 years. Less severe illness and being married were associated with a better outcome (Steketee Eisen & Dyck, 1999).

Most patients suffer a mixture of different obsessions or compulsions. Surveys have consistently identified contamination fears as the most common obsession, with concern about harm to others, pathological doubt, somatic obsessions and the need for symmetry also occurring frequently. Half of all OCD patients admitted for treatment suffer compulsions in the realm of repetitive checking or excessive cleaning and washing. 20 Key themes have been identified that underlie most symptoms. These include abnormal risk assessment, pathological doubt and incompleteness.

Patients with OCD usually retain full insight into the absurdity of their symptoms, although this is not always the case (Insel & Akiskal, 1986). The DSM-IV singles out patients with poor insight as a meaningful subgroup. These individuals have more complex symptomatology, which makes diagnosis more difficult, and tend to be more severely ill. They have only a limited sense of the excessiveness and irrationality of their thoughts and behaviours and are therefore difficult to engage in treatment. They may appear to be deluded (and hence receive inappropriate treatment) but longitudinal studies show they do not go on to develop schizophrenia-like illnesses. In a cohort of 475 patients with OCD, (6%) displayed lack of insight.

Mild forms of obsessional behaviour, such as repetitive checking or superstitious behaviour commonly occur in everyday life. They only meet the criteria for OCD if they are time-consuming, or associated with impairment or distress.

Recurrent, intrusive thoughts, impulses and images also occur in other mental disorders thought to share a relationship with OCD: for example, the preoccupation with bodily appearance, in body dysmorphic disorder; with a feared object, in specific phobia; with illness, in hypochondriasis; or with hair-pulling, in trichotillomania. A diagnosis of OCD should only be contrast; men predominate in surveys of OCD referrals, possibly reflecting a greater severity in males.

Women during pregnancy and the puerperium are particularly at risk of developing the disorder. In a study by Neziroglu et al of 59 mothers with OCD, experienced their symptoms for the first time during pregnancy. In many cases, pre-existing obsessional tendencies are unmasked and exaggerated by the events surrounding childbirth.

Obsessive compulsive disorder is considered to be one of the most strongly inherited mental disorders (Pauls, Alsobrook, & Goodman, 1995). Approximately one-fifth of nuclear family members of OCD sufferers show signs of OCD, and the younger the sufferer the more likely they are to have a first-degree relative affected. The clustering of OCD and Tourette’s syndrome (TS) within families suggests a common inherited factor.

The course of the illness can vary from a relatively benign form in which the patient experiences infrequent, discrete episodes of illness interspersed with symptom-free periods, to malignant OCD, characterized by unremitting symptoms and substantial social impairment.

In a 40-year prospective follow-up study, reported by Skoog and Skoog, the authors managed to locate and examine 144 out of 251 OCD patients who had previously been admitted as inpatients under their care between 1947 and 1953. 1Given that effective treatments for OCD were not developed until the end of the study, much of the data is naturalistic. The authors found that roughly 60% showed signs of general improvement within 10 years of onset of illness, rising to 80% by the end of the study.

However, only 20% achieved full remission even after nearly 50 years of illness; 60% continued to experience significant symptoms; 10% showed no improvement whatsoever; and another 10% had worsened. In 60% of cases the content of the obsessions shifted markedly over the follow-up period (Pauls, Alsobrook, & Goodman, 1995).

One-fifth of those who had shown an early, sustained improvement subsequently relapsed, even after 20 years without symptoms, suggesting early recovery does not rule out the possibility of very late relapse. Intermittent, episodic disease was common during the early stage of illness, and predicted a more favourable outcome, whereas chronic illness predominated in the later years.

Early age of onset, made if there are also unrelated obsessive-compulsive symptoms, in which case more than one diagnosis may be warranted. Activities such as preoccupation with eating, sex, shopping and gambling are not considered genuine compulsions because they are not egodystonic, and the individual usually only tries to resist because of the adverse consequences.

Reference:

Hollander E, Wong C, 1998). Psychosocial functions and economic costs of obsessive compulsive disorder, CNS Spectrums (3 (5) suppl. 1:48-58.

Insel T, Akiskal H, 1986. Obsessive compulsive disorder with psychotic features: a phenomenological analysis, Am J Psychiatry 143:1527-33.

Nelson E, Rice J, 1997. Stability of diagnosis of obsessive-compulsive disorder in the Epidemiological Catchment Area Study. Am J Psychiatry 154:826-31.

Pauls DL, Alsobrook JP, Goodman W et al, 1995). A family study of obsessive compulsive disorder, Am J Psychiatry 152 : 76-84.

Robins LN, Holzer JE, Weissman MM et al, 1984 Lifetime prevalence of specific psychiatric disorders in three sites, Arch Gen Psychiatry (1984) 41 :949-58.

Steketee G, Eisen J, Dyck I et al, (1999) Predictors of course in obsessive compulsive disorder, Psychiatr Res  89 (3):229-38.

 Weissman MM, Bland RC, Canino GL et al, 1994. The cross national epidemiology of obsessive-compulsive disorder, J Clin Psychiatry 55 :5-10.

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Attention-deficit Hyperactivity Disorder and Pharmaceutical Industry

Pharmaceuticalization can be defined as the “process by which social, behavioural or bodily conditions are treated or deemed to be in need of treatment, with medical drugs by doctors or patients” (Abraham 2010:604). According to Abraham (2010), pharmaceuticalization is currently on an upward spiral and this dramatic increase can be attributed to five different factors. These five explanations are biomedicalism, medicalization, pharmaceutical industry promotion and marketing, consumerism, and regulatory-state ideology or policy.

Each of these explanatory factors are mutually interactive but competing and it will be explained how this is in the following paragraphs. The biomedicalization thesis is based upon the idea that advances in biomedical research can explain why there is an expansion of drug treatment in our society today. Biomedicalism theorists believe that people who were previously undiagnosed or untreated for certain disorders are now able to receive necessary medication as a result of progression in medical science, but it is clear from his article that Abraham is not a biomedicalism theorist.

Abraham provides surprisingly large amounts of evidence to back up his claim that the biomedicalization thesis is not a legitimate explanation for the increase in pharmaceuticalization. Abraham criticizes the fact that a lot of the scientific literature contains uncertainties and many studies lack replicability and therefore should be rendered unreliable. He also uses the example of Attention Deficit Hyperactive Disorder (ADHD) to farther emphasize his argument.

He does this by making the point that the brain imaging done in these studies were supposed to be measuring the levels of dopamine in the brains of the subjects but these samples could not be taken from living people so were instead inferred from dopamine metabolites in the blood or urine. This poor quality of science that the biomedicalization thesis is based upon raises many questions and increases the likelihood that this is not a valid cause for the increase in pharmaceuticalization (Abraham 2010).

Abraham believes that medicalization is a more reasonable explanation for the rise in pharmaceuticalization. Pharmaceuticalization and medicalization often overlap but are nonetheless distinguishable. Medicalization can be defined as a “process by which non-medical problems become defined and treated as medical problems, usually in terms of illness or disorders” (Abraham 2010:604). The thought behind the increase in medicalization is that social deviance has gradually become redefined in a way that makes medical disorders part of the norm.

ADHD illustrates this idea because in the past 40 years, the criteria necessary to be diagnosed with this disorder has broadened drastically and some studies in the US found that almost 50% of children now meet this criteria. Another relevant disorder would be bipolar disease, which has increased 50-fold since 1980 when it was first entered into the Diagnostic and Statistical Manual of Mental Disorders (Abraham 2010). In our society today it is much more common to be diagnosed with a medical disorder and once consumers are made aware of a disorder’s existence, its regularity will skyrocket.

The main way in which consumers are informed about new drugs or diseases is from marketing and promotion done by the pharmaceutical manufacturers. Drug companies are advertising their products much more now and are over exaggerating the benefits in hopes to establish a larger consumer base. They are putting all of their resources and funds into this marketing and even spending more on this than resource and development: “In the US, industry expenditure on marketing has been about double that on R&D- US$54 billion and US$26 billion in 200, respectively” (Abraham 2010:609).

Pharmaceutical companies are even getting medical professionals on board to advertise their products either at medical symposia or in a television commercial by generously compensating them. This increased exposure to drugs makes consumers more informed about the availability of new drugs but not necessarily the risks that come along with them. In his article, Abraham mentions two forms of consumerism that have opposite effects of one another on pharmaceuticalization.

The first type that he talks about is adversarial consumerism, which occurs when people are under the impression that they have been harmed by specific drugs and therefore pursue legal actions against pharmaceutical manufacturers. Adversarial consumerism is currently rising; in 2000, US plaintiffs received 4. 85 billion US dollars to settle 27,000 lawsuits against Merck and 894 million US dollars against Pfizer to settle lawsuits about various types of arthritis drugs. These figures can be compared with the mere 10’s of millions of dollars that Eli Lilly was charged with in the 1980s.

This particular type of consumerism actually leads to a decrease in pharmaceuticalization, which is sometimes referred to as de-pharmaceuticalization (Abraham 2010). The more powerful type of consumerism is called access-oriented collaborative and it is one of the reasons that there is an increase in pharmaceuticalization in our society today. This form of consumerism occurs when patients seek access to new drugs quicker than the Food and Drug Administration (FDA) can approve them. This puts a lot of pressure on the FDA and forces them to cut approval times for highly demanded drugs (Abraham 2010).

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Post Traumatic Stress Disorder in War Veterans

POST TRAUMATIC STRESS DISORDER IN WAR VETERANS SC-PNG-0000009299 Alwin Aanand Thomson American Degree Program SEGi College Penang 1. 0 INTRODUCTION Posttraumatic stress disorder (PTSD) is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one’s own or someone else’s physical, sexual, or psychological integrity, overwhelming the individual’s ability to cope.

As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress response. Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal—such as difficulty falling or staying asleep, anger, and hyper vigilance. Formal diagnostic criteria in DSM-IV-TR require that the symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning (American Psychological Association). . 0 DIAGNOSIS Criteria The diagnostic criteria for PTSD, stipulated in the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as: A: Exposure to a traumatic event This must have involved both (a) loss of “physical integrity”, or risk of serious injury or death, to self or others, and (b) a response to the event that involved intense fear, horror, or helplessness (or in children, the response must involve disorganized or agitated behavior). The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause “significant symptoms of distress in almost anyone,” and that the event was “outside the range of usual human experience. ” B: Persistent re-experiencing One or more of these must be present in the victim: flashback memories, recurring distressing dreams, subjective re-experiencing of the traumatic event(s), or intense negative psychological or physiological response to any objective or subjective. C: Persistent avoidance and emotional numbing

This involves a sufficient level of: • avoidance of stimuli associated with the trauma, such as certain thoughts or feelings, or talking about the event(s); • avoidance of behaviors, places, or people that might lead to distressing memories; • inability to recall major parts of the trauma(s), or decreased involvement in significant life activities; • decreased capacity (down to complete inability) to feel certain feelings; • an expectation that one’s future will be somehow constrained in ways not normal to other people. D: Persistent symptoms of increased arousal not present before

These are all physiological response issues, such as difficulty falling or staying asleep, or problems with anger, concentration, or hypervigilance. E: Duration of symptoms for more than 1 month If all other criteria are present, but 30 days have not elapsed, the individual is diagnosed with Acute stress disorder. F: Significant impairment The symptoms reported must lead to “clinically significant distress or impairment” of major domains of life activity, such as social relations, occupational activities, or other “important areas of functioning”. (DSM-IV-TR, American Psychiatric Assocation) . 0 PTSD IN WAR VETERANS 3. 1 Facts & Figures Operation Iraqi Freedom has become the deadliest American military conflict since the Vietnam War. Uto 13 percent of the troops returning from the deployment have reported symptoms of post-traumatic stress disorder (PTSD). With the daily violence in this war torn country, service men and women are subjected to increased levels of stress which can trigger PTSD. After fighting for their country and risking their lives, allowing them to return home only to be haunted by their actions degrades everything they were sent to Iraq to accomplish.

Since the Vietnam War, methods of treating PTSD have developed and lowered the number of cases, but simply lowering the number of cases is not good enough. Unless service members can be prevented from experiencing these negative emotions, every one of them is engaged in a possible suicide mission. With the proper procedures introduced and carried out as proposed, not only the service members can be helped, but their families as well. Due to current operations in the Middle East and the recent combat operations in the past decade, many citizens have met somebody who has experienced their share of combat related stress.

When you look at somebody who has been in combat, they may look like your average person on the outside, but on the inside lays memories of the violent scenes of war torn countries. Their mental health may not be noticeably altered, but they could very well suffer from haunting memories, flashbacks, and even post-traumatic stress disorder. Post-traumatic stress disorder (PTSD) can produce emotional responses caused by the trauma endured during combat operations. It does not have to emerge immediately, but can actually happen weeks, months, or even years after the traumatic event.

PTSD was often referred to as “combat fatigue” or “shell shock” until 1980 when it was given the name post-traumatic stress disorder. According to William Welch of USA Today, PTSD is produced from a traumatic event that provoked intense fear, helplessness, or horror. The events are sometimes re-experienced through intrusive memories, nightmares, hallucinations, or flashbacks. Symptoms of PTSD include troubled sleep, irritability, anger, poor concentration, hyper vigilance, and exaggerated responses.

Emotions felt by victims of PTSD include depression, detachment or estrangement, guilt, intense anxiety, panic, and other negative emotions (2005). Out of over 240,000 veterans of Iraq and Afghanistan already discharged from the service, nearly 13,000 have been in U. S. Department of Veterans Affairs (VA) counseling centers for readjustment problems and symptoms associated with PTSD (Welch, 2005). Operation Iraqi Freedom has become the deadliest American conflict since the Vietnam War and because of this, new data detailed by Cep79m. v shows that 12 to 13 percent of troops returning from Iraq reported PTSD symptoms while about 3 to 4 percent reported other mental distress. A new Army study found that 11 percent of troops returning from Afghanistan reported symptoms of mental distress. Although wartime psychology was just beginning during the Vietnam War era, later studies showed that nearly 15 percent of troops who served there suffered PTSD. The most recent studies found that nearly 30 percent of the Vietnam War veterans have developed physiological problems after returning from the war.

PTSD estimates for veterans of the first Gulf War range between 2 and 10 percent (2004). These numbers are based on several key factors. The amount of combat related stress varies by unit and will determine the amount of emotional stress a soldier in that particular unit will experience. For example, according to The New England Journal of Medicine, out of 1709 Soldiers and Marines surveyed, those who returned from Iraq reported higher rates of combat experience and frequency than those returning from Afghanistan. It’s probable that those who experience more combat situations are more likely to suffer to PTSD.

As noted in The New England Journal of Medicine, out of those surveyed, 71 to 86 percent deployed to Iraq reported engaging in a firefight as apposed to only 31 percent in Afghanistan. Soldiers and Marines returning from Iraq were significantly more likely to report that they were currently experiencing a mental health problem, were interested in receiving help for their mental problems, and actually used mental health services (Hoge et al, 2004). As noted earlier, according to William Welch of USA Today, PTSD is produced from a traumatic event that provoked intense fear, helplessness, or horror (2005).

Being wounded while in combat is a perfect example of an event which provokes intense fear. Among those who participated in a recent survey, 11. 6 percent reported being wounded or injured while in Iraq compared to 4. 6 percent of those in Afghanistan (Hoge et al, 2004). This is a clear indication that the events a soldier experiences during deployment will have influence on the possibility of PTSD after redeploying to the United States. Intense situations do not revolve around being wounded or injured. Operation Iraqi Freedom has become the deadliest American conflict since the Vietnam War.

As a result, CNN notes that 90 percent of those who served in Iraq reported being shot at. A high percentage also reported killing an enemy combatant, or knowing somebody who was injured or killed. Approximately half said they handled a body while serving in Iraq (2004). In addition to CNN’s article, Cep79m. tv announced amazing data showing one in four Marines reported killing an Iraqi civilian while one in four Army soldiers reported engaging in hand-to-hand combat. More than 85 percent of those surveyed know somebody who has been injured or killed. More than half claimed handling corpses or human remains (2004). 3. Treatment and Prevention There is help available to those returning from the war torn countries. Almost 17 percent of the troops surveyed, who served in Iraq, suffered mental health problems while less than half of them have looked for professional help after ending their tours (Cep79m. tv, 2004). Sergeant First Class (SFC) Doug Sample of the American Forces Press Service reports that “service members can get confidential counseling through the military services’ ‘One Source’ program. The 24-hour-a-day service is for service members and their families, and provides quick, professional assistance with problems” (2004).

The reason only half of them are seeking help could be the possibility of negative attention from their unit. Dr. William Winkenwerder says that a main barrier preventing soldiers from getting help “is the perception of stigma that some individuals have about coming forward to get that care and counseling” (Gilmore, 2004). CNN interviewed Staff Sergeant (SSG) Georg-Andreas Pogany who saw an Iraqi body which had suffered severe trauma on his second day in Iraq. Suffering from a nervous breakdown and struggling to sleep that night, he decided to tell his superior officer.

He was afraid he would freeze up on patrol and was worried about the consequences. Instead of being given help, he was told to reconsider his concerns for the sake of his career. A translator attached to the 10th Special Forces Group was sent back and charged with cowardice after experiencing the same type of emotional stress. Though his charge was dropped, his record is still uncertain (2004). Post-traumatic stress disorder may not be preventable in every individual who steps foot inside a combat zone, but things can be done to lower the number of cases which occur after deploying.

The army, for example, works under a “tough and realistic training” motto. They train their soldiers during peacetime as if they were actually in a combat zone. Live-fire ranges along with tough and realistic training have helped soldiers prepare for combat and the numbers developed from the data is surprisingly low. But that doesn’t surprise many people because according to Gilmore, they have used information from former prisoners of wars to help train today’s service members to be ready for combat (2004). The military works on a schedule allowing units to use live fire ranges at certain times with a certain number of live rounds.

A possibility to help lower the amount of PTSD cases related to intense combat situations would be allowing soldiers to use live fire ranges more often. If this means raising taxes a little more to allow for a larger budget, then by all means, it’s worth it. Before, during, and after deployment, service members are given counseling sessions to prepare them for intense situations as well as teaching them about the possibility of mental health damage. This has been a change since the Vietnam War, which could be another factor which has helped lower the amount of PTSD cases throughout the military.

Another possible solution to PTSD would be to brief soldiers throughout their entire career. Before Operation Enduring Freedom, it had been nearly 10 years since the last major conflict which involved ground forces. In those 10 years, if soldiers were given briefings on the possibility of mental health damage after combat, there is a chance they would have been more prepared to deal with those situations. The Department of Defense could easily make it mandatory that each service member receives several briefings each year during their entire military career to include during deployments. Citing recent Centers for Disease Control and Prevention research, Winkenwerder noted some people seem more predisposed to develop depression, anxiety, or post-traumatic stress disorders as a result of negative childhood experiences” (Gilmore, 2004). Apparently, the better the life a child has while growing up, the more ready for combat they will be. The Department of Defense requires each applicant for the armed forces to take a test which allows them to qualify for a certain job within the military.

Another possibility would be adding a section to the test which measures the type of childhood an applicant experienced. They could then choose only those who did not have many negative childhood experiences, if that statement is at all accurate, to fill their combat oriented positions. 4. 0CONCLUSION According to the data gathered during recent surveys, it is clear that although the violence of war will remain the same, it is possible to lower the percentage of service members who experience mental disturbance such as post-traumatic stress disorder from combat situations. It may be impossible o completely rid the volunteer force of the possibility of PTSD, but with enough counseling before, during, and after combat operations, the percentage of those who suffer from it may be lowered dramatically. More tough and realistic training will also help set soldiers into the mindset of what it takes to survive a combat situation. The treatment and prevention is there, but does not seem to be used quite enough. Not using the prevention methods is almost like sending our troops on a suicide mission. Cep79m. tv, (2004, July 1). Soldier Mental Illness Hits Vietnam Level. Retrieved April 6, 2012 from http://www. cep79m. v/soldiermentalillness. htm (http://www. cep79m. tv/soldiermentalillness. htm) CNN, (2004, July 1). Combat stress: The war within. Retrieved April 10, 2012 from http://www. cnn. com/2004/HEALTH/07/01/post. traumatic. stress/ (http://www. cnn. com/2004/HEALTH/07/01/post. traumatic. stress/) Gilmore, G. , (2004, July 1). Combat Degrades Some Troops’ Mental Health, Report Says. Retrieved April 16, 2012 from http://www. defenselink. mil/news/Jul2004/n07012004_2004070106. html (http://www. defenselink. mil/news/Jul2004/n07012004_2004070106. html) Welch, W. , (2005, February 28). Trauma of Iraq War Haunting Thousands Returning Home.

Retrieved April 16, 2012 from http://www. commondreams. org/cgi-bin/print. cgi? file=/headlines05/0228-01. htm (http://www. commondreams. org/cgi-bin/print. cgi? file=/headlines05/0228-01. htm) NIMH · Post Traumatic Stress Disorder Research Fact Sheet”. National Institutes of Mental Health. Retrieved April 16, 2012 from http://www. nimh. org/ptsdfactsheet/ A soldier carrying his wounded compatriot Smoking as a common stress reliever among soldiers. Traumatic flashback occurring on duty. Anti-depressants are common among veterans. Traumatic enough to bring the toughest of men to tears.

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Eating Disorders

English 201A 17 September 2012 Annotated Bibliography on Eating Disorders Champion, Helen and Adrian Furnham. “The Effect of the Media on Body Satisfaction Adolescent Girls. ” European Eating Disorders Review 7. 3(Jun 1999):213-28. Academic Search Premier. Web. 10 Sept 2012. In this particular piece of article its purpose suggests that the influence of media, in constantly identifying thin, stereotypically attractive bodies, provokes a sensation of body dissatisfaction and consequently is somewhat responsible for the increase in eating disorders among young women.

A recent study by Ogden and Mundray (1996) suggests that in presenting images of thin attractive individuals’ increases the body dissatisfaction. While in presenting images of larger overweight individuals somehow gives an alleviating effect. The study attempted to investigate this effect in adolescent girls. The results were not as expected and failed to support the experimental assumption. However possible reasons for this are addressed. It is suggested that the media’s influence on individuals’ self-evaluations may be more difficult than Ogden and Mundray’s results imply in their observations.

Fursland, Athea, Sharon Byrne, Hunna Watson, Michelle La Puma, Karina Allen, and Susan Byrne. “Enhanced Cognitive Behavior Therapy: A Single Treatment for All Eating Disorders. ” Journal of Counseling ; Development 90. 3(Jul2012):319-29. Academic Search Premier. Web. 10 Sept 2012. In this particular piece it addresses eating disorders as a serious mental illness that is affecting a wide number of women and a small portion of men. This piece suggests all counseling expertise should have knowledge of eating disorder and treatment possibilities.

This also goes on explaining how the stage of the treatment therapy unfolds and develops into a helpful stage for the victim with an eating disorder. Guavin,lise and Howard Steiger. “Overcoming the Unhealthy Pursuit of Thinness: Reaction to the Quebec Charter for a Healthy and Diverse Image. ” American Journal of Public Health 102. 8(Aug 2012):1600-06. Academic Search Primeir. Web. 10 Sept 2012. In this piece of article it is suggested that in order to measure the ontribution of an initiative to overcome the unhealthy pursuit of thinness, an exam of the population reach, acceptability, and perceived potential of an initiative that developed a promotional tool for a healthy body image, the Quebec Charter for a Healthy and Diverse Body Image aimed to reduce the pressures from extreme thinness. The Charter was developed through consensus building by a government led task outlined actions to be undertaken by organizations or citizens to reduce media pressures favoring thinness.

Studies and findings also showed that men and women with higher education were more highly reached than those who with less education standards. Also resulting in the studies that not all targets were being executed and those with a possibility of having higher risks were not responding in the pursuit of overcoming unhealthy thinness. Martinez-Gonzalez, Miguel Angel, and Pilar Gual. “Parental Factors, Mass Media Influences, and the Onset of Eating Disorders in a Prospective Population- Based Cohert. ” Pediatrics 111. 2(Feb 2003): 315-16. Academic Search Premier.

Web. 10 Sept 2012. In this particular article their understanding was set to identify risk factors for eating disorders. A community company study was conducted in Navarra, Spain. The study of 2862 girls who were 12 to 21 years of age completed the Eating Attitudes Test and other questionnaires. Girls who scored high in the Eating Attitudes Test were interviewed by a psychiatrist who applied Diagnostic and Statistical Manual of Mental Disorders. Girls who were free of any eating disorder were reassessed after 18 months of follow-up using the same methods.

The results were that ninety new cases of eating disorders according to Diagnostic and Statistical Manual of Mental Disorders were identified during the follow-up. Our results support the role of mass media influences and parental marital status in the onset of eating disorders. The habit of eating alone should be considered as a warning sign of eating disorders. Radford, Benjamin. “Media and the Mental Health Myths: Deconstructing Barbie and Bridget Jone. ” Scientific Review of Mental Health Practices 5. 1(2007):81-7. Academic Search Premier. Web. 10 Sept 2012. Thompson, Kevin J. nd Eric Stice. “Thin – Ideal Internalization: Mounting Evidence for a New Risk Factor of Body Image Disturbance and Eating Pathology. ” Current Directions in Psychological Science 10. 5(Oct 2001):181-83. Academic Search Premier. Web. 10 Sept 2012. In this particular article according to studies and experimental trails conducted in labs over the past decade suggests that thin-ideal internalization is an important risk factor for creating body image and eating disorders. Also noting of prospective risk factors and variables that may alter and add to the studies done before.

Physical and mental problems are important risk factors that initiate from the discomfort of the body image and eating disorders. Findings from studies suggest that internalization is a causal risk factor for body-image and eating disorders, and that it appears to fulfill in conjunction with other established risk factors for these outcomes, including dieting and negative affect. Future research is needed to examine the specific factors like perhaps family, peer, and media influences that promote internalization and also to replicate and extend prospective and experimental studies. (836)

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The Negative Effects of the Fashion Industry on Eating Disorders

ENG 150 18 October 2012 The Negative Effects of the Fashion Industry on Eating Disorders While it’s fashion week in London, the size “zero” models start to prepare for the big show by purging to be as thin as possible. Most models starve themselves in order to achieve the “waif”, stick-thin figure; it becomes so addictive, almost like second nature that it further leads to serious eating disorders. From recent studies, today’s model weighs about 23% less than the normal woman. Clearly, most models do not depict the average woman. Men and women all over the world follow the influences that the fashion industry provides.

They believe that the fashion industry depicts on what society should be acknowledged as, picture-perfect thin. Most models look like they had descended from heaven, but in reality they live in a sad world where body image is what is considered beautiful and they would do just about anything to achieve it. Society is also taking a nose dive into this self-deprecating environment, where it is definitely not healthy for a person to develop and thrive. As Naomi Hooke, anorexia survivor, acknowledges, “Anorexia has often been perceived as a quest for model-like beauty . . many anorexics detest their bodies,” she then further goes into detail how this industry became her downfall (3). These waifish models on the runway cause major damage in the well-being of many, as well as their own; they create body image complexes that haunt women forever. Yes, the fashion industry is well known for the classic thin models, although in the 1950’s models symbolized the beauty of the average woman, full figured and all, but today’s models should not depict to an individual on what they should be perceived to look like, yet it happens every day.

When a victim of eating disorders views a model, they think, “Why am I so fat? Why don’t I look like her? What do I need to do to look like that? ” The confidence and the self-worth of these victims start to fall short, although some begin to find solutions to their problems. According to Paul Casciato, of Reuters. com, almost 9 out of 10 teenage girls said they feel pressured to be skinny by the fashion industry and media. A large contributing factor to this problem is that many people in the fashion world encourage the use of overly thin models in editorials and fashion shows.

For example, as Kathryn Shattuck, What’s On Today: [The Arts/Cultural Desk], mentions that Kelly Cutrone, world renowned fashion publicist, encourages, “Clothes look better on thin people. The fabric hangs better” (1). The fashion industry’s emphasis on being thin and its use of extremely underweight models in unacceptable. Many people would agree that the fashion industry plays the majority role in eating disorders, but Lisa Hilton, British Vogue writer, disagrees. Hilton argues, “Its objective is selling clothes, and the consensus remains that in order to achieve this, models need to be thin . . Fashion is about fantasy, about impossibility, about, dare we say it, art. Most women can’t tell the difference” (1). Hilton condescendingly continues to refute the criticisms that models are too thin and the fashion industry encourages eating disorders. More recently, Sports Illustrated model, Kate Upton whom is a size 4, is now considered a plus size model and deemed to be “too curvy”. In the United States the “normal” sized woman is between the size of 6 and 10. Most of us do not understand why some put themselves through so much anguish to satisfy these body image complexes.

Back in the 1950’s, models were absolutely glamorous, they were healthy and had meat on their bones. The average height of a model is 5’10” and weighs approximately 120 pounds whereas the average women with a height of 5’10” weigh about 145 pounds. This is a significant and disturbing difference. As Hooke emphasizes, “Sufferers are often presumed to pore over the pages of glossy magazines and starve themselves in their aspirations to become glamorous, thinner-than-thin sex goddesses,” she then concludes how the industry destroyed her life.

Women give in and fall into temptation, but why? These “normal” women are beautiful they way they are, but in fashion terms, they are considered morbidly obese in comparison. As Holly Brubach, New York Times Magazine journalist, argues, Models starve themselves the way football players take steroids, jeopardizing their health and longevity for celebrity and wealth. More surprising, perhaps, and certainly no less alarming, is it the realization that dieting as become so commonplace that the skeletons on the catwalk simply strike us as more expert than the rest of us (1). As Brucach further describes how the fashion industry and their models compel everyday women to give up meals, she also observes that the Internet provides sufferers starvation tips. Commonly called promote anorexia, or “pro anas”. There are many blogs and forums that pro anas flock to for tips. One teenage girl professed, “Splurged and had 7 grapes, I can’t believe it. I cannot eat tomorrow.

Please send skinny thoughts my way! ” Another pro ana, calls herself MelancholyMiss states in forum Lard Ass Rant Time, “Starting to feel that swimmy feeling in my head again . . . I’m trying to tell myself I need to eat a little something so I can have some energy. No, my hard work won’t go to waste. I’m spinning, spinning down into the depths of self loathing, misery, isolation. ” What these women go through on a day to day basis is just horrendous. It’s truly sickening. What drives these sufferers is beyond most.

Isabelle Caro, a French model and actress who became the international face of anorexia when she allowed her ravaged body to be photographed nude for an Italian advertising campaign to raise awareness about the disease. Italian fashion label, Nolita, had photographed Caro at 26 years old weighing only 59 pounds. When Caro was featured on an episode of Taboo on the National Geographic channel, she claimed that she tried getting help but in her line of work, it was not possible and that if she gained weight she would lose her job.

Neil Katz of CBS News, describes the billboard as, “[Her] face was emaciated, her arms and legs mere sticks, her teeth seemingly too large for her mouth” (2). In Katz’ article, Caro confirms, “I decided to do it to warn girls about the danger of diets and of fashion commandments” (1). In 2006, she reached the weight of 52 pounds. She sank into a coma and after months of extensive care she reached weight of 93 pounds. Although the major effort put into changing her life around, she was still remained in crucial health.

Her body could not handle the major back and forth transformation that her body failed and died. She died at only 28. In her memoir, The Little Girl Who Didn’t Want to Get Fat, her dying wish was to raise attention and eliminate anorexia and other eating disorders. There are numerous ways to change the fashion industry’s negative reputation. The Council of Fashion Designers of America has created the CDFA initiative, which is implementing certain designers and magazines to fix said problem.

The CFDA’s ideas include offering models that have been identified as having an eating disorder to seek professional help and not be able to work without a medical consent. Other ideal solutions include supplying healthy foods during photo shoots and shows; also educate models about eating disorders. Although, these solutions seem ideal, but won’t become obsolete. There must be harsher regulations where healthy women, of certain weight requirements, can become models. This industry must defend its reputation and end the horrible habit of girls starving themselves to look like unrealistic and photo-shopped

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Post Traumatic Stress Disorder

Post-Traumatic Stress Disorder Post-Traumatic Stress Disorder is a very serious psychological disorder many ordinary people can develop. It causes large scale depression and can severely damage relationships and lives. Its main causes are from a person experiencing or witnessing an event involving death or serious injury. A person’s response to the trauma usually involves fear, helplessness or horror. In children evidence of Post-Traumatic Stress Disorder (PTSD) can be exhibited in disorganized or agitated behaviors.

One of the most common side effects of PTSD in adults is the recurring thoughts, images and perceptions about the specific trauma they endured. Consistent, frightening dreams of the event are also signs of developing PTSD. For children, they may also experience frightening dreams but with unrecognizable content they might not understand too well. Adults can also exhibit signs by acting as if they were reliving the events over and over again. Another sign of PTSD is the avoidance of thoughts, feelings and conversations with others about what happened, and the restricted range of affections and emotions exhibited by the individual.

Many people feel like they are unable to have loving feelings and can have a sense of a foreshortened future where they can’t picture themselves having a career, marriage, children or even a normal life span. In most cases, the symptoms of PTSD begin to surface around 3 months after the specific event, but can be seen or experienced earlier as well. The symptoms generally tend to stay around for not too long of a time but for some people it can become chronic and never go away for as long as they live. Victims can begin to feel detached from society and estranged by their peers and others, as if they were all alone with no one there for them.

Victims can also have difficulties concentrating, become hyper vigilant, which means a person has an increased state of anxiety and is constantly scanning their surroundings for threats, and exaggerated startled responses which is a side effect of all the anxiety they’re putting their minds through. Along with high states of anxiety, difficulty sleeping, extreme irritability, outbursts of anger for non-important reasons and severe depression are seen in many PTSD patients. Symptoms have been known to be worse when the trauma experienced is from intentional human actions rather than something like a natural disaster.

Also, when something involves mass casualties like war, someone who survives can experience something known as survivor’s guilt where they feel guilty for getting through it meanwhile they lost loved ones and friends. The most vivid, disturbing way to experience PTSD is through a flashback. A flashback is when a person has recurring images flash before him when looking at normal things and cause the victim to be transported back to where the trauma took place and even begin to make the person feel, see, and smell the things he might’ve on that day or time period.

This is especially common with war veterans like Vietnam War veterans. Vietnam War veterans can and have been known to be upset by war movies, hot humid weather, and even Asian cooking as it brings them back to the times when they were overseas and where they lost a lot of friends. PTSD has always been closely tied to the history of human warfare, not just the Vietnam War. PTSD is also known to soldiers and veterans as soldier’s heart, combat neurosis, and battle fatigue, meaning a soldier can lose their will to live and fight and just want to give up.

Combat veterans who have witnessed or committed violent acts are more likely to develop PTSD. The men who liberated the Nazi war camps in the 1940’s could have been Severely distressed by the things they saw were being done to people. And through to today in the prisons the United States has where they keep war criminals and suspected terrorists like Abu Ghraib. Soldiers who were stationed there had seen some horrific things done to people, and those images could stick with them for a very long time.

However, it was not until after the Vietnam War that PTSD became a well-known and serious mental health condition and captured the interest of doctors and psychiatrists. A study done on Vietnam War veterans showed that at least 1. 7 million veterans had experienced a serious case of PTSD when their tour was over or after the war. The attention received by the Vietnam War veterans also helped shed a light onto victims of other wars and events and allowed the still living Holocaust survivors to seek help if they wished.

Another study showed that 55% of women were victims of a violent crime and that one in four of these women suffered from PTSD. It can affect everyone for an unlimited amount of reason ranging from natural disasters like a hurricane or earthquake to something more recent like the terrorist attack of September 11, 2001. Many civilians who escaped New York City that day saw and experienced some of the worst things imaginable, and one of the largest groups of people who suffered from that event was the members of the FDNY, NYPD, and PAPD.

With the FDNY losing 343 firemen, the NYPD losing 23 police officers and the PAPD losing 7 officers, the first responders to the World Trade Center suffered heavy casualties. A lot of people lost fellow brothers and sisters going into the buildings attempting to save innocent civilians and lost their lives. A horrific event like 9/11 affects a larger amount of people and hits them harder than other things due to the severity, lives lost, and pointlessness of the attack. People who already may have underlying or prior mental health problems are more likely to develop PTSD.

Genetics also play a role in making some people susceptible to PTSD and two people who are experiencing the same trauma can have two different outcomes. One person might be able to get through it and the other might be completely mentally exhausted and suffer the worst of the symptoms. People may not even know they have PTSD until the death of a close friend or relative or a divorce or something life changing brings them to an emotional low and can make them recall what they may have gone through.

PTSD is a serious mental condition that affects more people than anyone might know. Some people are good at hiding feelings while others are not. Sadly some sufferers resort to using heavy quantities of alcohol and tranquilizers to numb their pain and make them able to cope with the disturbing recollections, nightmares and sleep problems and sadly many end up dependent on the drugs they’re using. PTSD can also lead to suicide if the victim experiences sever amounts of survivor’s guilt or feels as if they can’t take it anymore. Works Cited: . Vrana, Scott. “Post-Traumatic Stress Disorder. ” Salem Health Psychology & Mental Health. First edition. Editor: Nancy Piotrowski. Volume 4 Pasadena, CA: Salem Press, 2010. Print. 2. Miller, Allen, “Living With Anxiety Disorders” New York, Facts on File, 2008. Print 3. Jan Fawcett, “Post Traumatic Stress Disorder” The Encyclopedia of Mental Health Ada Kahn. First Edition. Volume 1 New York. Facts on File. 1993. Print. 4. nymag. com/news/articles/wtc/1year/numbers, New York Magazine, 11 September 2011. Web. 20 November 2011

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Facebook Addiction Disorder

Article 1 Title : Online Social Networking and Addiction Writer(s) : Daria J. Kuss and Mark D. Griffiths Source : www. mdpi. com/journal/ijerph Social Networking Sites (SNS) or in this case Facebook has been causing serious addiction amongst individuals these days. This situation is no longer seen as an addiction but as a serious mental health issue. People these days spend majority of their time online by surfing Facebook in their virtual community. Psychologists describe this scenario as ‘Facebook Addiction Disorder’ (FAD).

This disorder is seen as an addiction because the individual who is said to be addicted to Facebook actually confronts similar criteria as other addictive activities. One is said to be having FAD due to the increase in time spent on Facebook. Besides that, FAD also increases individualistic culture among its users. Moreover, egocentrism is another factor that contributes to this problem since it may induce addictive characteristics within the particular individual. This is mainly down to attraction which is the key factor to Facebook Addiction Disorder.

Furthermore, like any other addiction, this issue has its symptoms as well. The author has addressed several symptoms that can be used to classify a person as a Facebook addict. Negligence of personal life, mental preoccupation, escapism, mood modifying experiences, tolerance, and concealing the addictive behavior are among the symptoms that can be seen in a Facebook addict. These symptoms are detrimental to one’s mental health and well being because the person spends too much of time and energy in a virtual world.

The effects of Facebook addiction or behavioral-related addiction and substance-related addiction is suggested to be the same as both have negative consequences on the addict as time goes by. (259 words) Article 2 Title : Facebook Addiction Disorder – The 6 Symptoms of F. A. D. Writer : Amy Summers Source : www. socialtimes. com This article touches on the issue of Facebook Addiction Disorder, amongst teenagers and its effect on their surroundings. This occurrence is the latest obsession and a virtual object of craze amongst teenagers.

This is mainly due to Facebook being the current big thing everywhere that even family members of the teenagers till educated professionals are going mad over the social networking site. These teenagers tend to go overboard when they participate in this phenomenon as it is a trend that is considered uber- cool and they become obsessive about it. “Facebook Addiction Disorder” (FAD) is a condition which is defined by hours spent on Facebook by a person. The time spent is said to be affecting the balance of an individual’s life.

There are six key symptoms mentioned by the author for this disorder. Firstly, a person with FAD will be spending so much time on the site which leads to a stage where they need it in order to obtain satisfaction. Besides, reducing normal social or recreational activities, they will also plan virtual dates as instead of meeting their partner somewhere, they will ask their partner to be online at a certain time. Other than that, the friends list of an addict will mostly have strangers rather than the ones they know in real life.

Finally, the sign of complete addiction is when they introduce themselves to someone and promise to see them on Facebook. Parents who try to help their children out of this problem, turn out to be more addicted than their teenage kids. (257 words) REFLECTION Facebook. Something that started off within the walls of Harvard University in 2004 has been ruling the world for the past half decade. Newborn babies to near death grannies and even animals these days have a profile on this social networking site. This site has been so major that these days the first word that type into the World Wide Web is Facebook. 45 million users in just 8 years is a quite a record for any social networking site in the world. It has been so hyped up that to have a Facebook profile has become a basic need for certain group of people. A tool that is supposed to be used prudently has been used extensively by some individuals so much so that they have become addicted to it. In fact, psychologists in the United States of America came up with the term ‘Facebook Addiction Disorder’ (FAD) back in 2009 as they predicted this syndrome will take the world faster than it took for the site to become global.

Well, their prediction has become true. This condition is considered to a serious mental illness these days, even worse since it’s caused by addiction that could be compared to the likes of drugs and cigarettes. Who would’ve thought that a social networking site could spell so much trouble? Based on the two articles, the key point to this disorder is due to the amount of time spent on this site. People tend to spend too much time on this site than actually do something about their lives.

Those days when a working man gets his off day, he would be either having a good sleep or spend some quality time with his family, but nowadays the working man would rather spend his off day by enduring a sleepless night just to spend his time on Facebook. This sounds totally ridiculous. In the context of students, they would be glad to chat with their friends online, upload pictures and update their status but they would not bother to even flip through their textbooks or homeworks given by the teacher. This proves that Facebook is affecting people regardless of age limit.

The amount of time spent on Facebook shows the level of addiction of the person to the site. Thus, the hypothesis would be that, the more the time taken to use Facebook, the higher the addiction level. A person who is possessed with this global demon is also very dangerous as it may make you oblivious to your surroundings. Facebook addicts do not care about what’s happening around them. However, they would ‘like’ a certain post about Earth Hour during the hour when all electric appliances should be shut down.

This shows how a person can be an environmentalist in the virtual world, but a person with no social awareness in reality. This means that Facebook addicts have another problem, Multiple Personality Disorder because they have two avatars, each in two different worlds, Facebook and reality. This disorder also causes people to be very aggressive. They would be very sad if a friend did not respond to their request to be friends on Facebook. Some of them would even compete with each other to increase their list of friends.

This situation could not be considered as something that tickles our funny bones, but it is something that should be thought rationally and seriously since the issue is getting worse day to day. What is the point of adding a thousand people into your profile and chat with them happily online, when you turn your back towards them in reality? Besides that, the majority of group that is most affected by this phenomenon are teenagers. Being born in this era of online madness is not a sin, but they are being led into fake world that is given a fancy name of globalization!

They think that being on Facebook is the coolest thing to do as a teenager. What a misconception? Students these days do not prefer face to face interaction where as they prefer to virtual communication. Do not be surprised if in the future two people, who won’t even smile at each other, could be best friends on Facebook. If the number of Facebook addicts increase continuously, sooner or later we would be witnessing the growth of an unhealthy generation of youth with no social skills because all this while they never knew how to make friends, socialize or even take part in recreational activities.

The major factor to this crisis is because their conceptualization of social life is Facebook. This so called social networking site also happens to social crime networking site lately. On 18th April 2012, in Pune, India, a 16 year old girl was kidnapped by her Facebook friend whom she had known through the website. After kidnapping her, the accused initially demanded a ransom of Rs 100,000 from her mother. But later fearing police action, he got the girl admitted to a private hospital telling the hospital authorities that he found her ‘wandering’ on the road after she was thrown out of a van by some people.

What could have happened to the girl if the kidnapper was a psychopath? The consequence would have been unfathomable. This is what happens to certain Facebook addicts who reveal too much of details online. What is the worth of an individual who is deemed as a very private person in reality, where as in the virtual world they reveal everything to everyone? In the working world, those days’ workers were scolded by their employers for talking during their work time; nowadays they are sacked for using Facebook at work.

In certain scenarios, the employees are sacked because they update their Facebook status at work, capture pictures while working and also to have the guts to upload it at work. Where is the discipline of the working world going? Why are they being so irresponsible? In a book titled ‘Facebook Addiction’, the author who is an addict himself says that once when he was trying to pack up his laptop, a client called and asked him to work on a website. The moment he opened the internet browser, the first thing he did was, type in “www. acebook. com” and logged in, he promised to himself to spend only five minutes, he couldn’t resist himself and spent eight hours on the website. On top of that, in terms of relationships, Facebook addicts do not have a proper life there either; there have been reported cases in America, of young married couples who file for divorce. In a survey conducted by the American Academy of Matrimonial Lawyers (AAML), researchers found that Facebook was mentioned in 1 out of every 5 divorces in the United States.

Some of the cases were due to lack communication between couples because one of the partners was always busy updating his Facebook status rather than actually communicating with his wife. Before marriage, messaging through the site could be fun or romantic, however post marital relationship requires commitment and real communication. These cases have proved that Facebook Addiction Disorder has been the major cause of many serious problems from school to the confinements of our home. If this scenario continues, this disorder could get into the line along serious mental illnesses.

We as educators will be facing great dilemmas as the students would be more passive socially in reality, to overcome it we have to teach them in a condition where there is no active interaction between teacher and a student. However, if we stand with our hands folded, one day we might see the portrait of our society in the obituary column in the newspapers. APPENDIX Article 1 Title : Online Social Networking and Addiction Writer(s) : Daria J. Kuss and Mark D. Griffiths Source : www. mdpi. com/journal/ijerph “I’m an addict.

I just get lost in Facebook” replies a young mother when asked why she does not see herself able to help her daughter with her homework. Instead of supporting her child, she spends her time chatting and browsing the social networking site . This case, while extreme, is suggestive of a potential new mental health problem that emerges as Internet social networks proliferate. Newspaper stories have also reported similar cases, suggesting that the popular press was early to discern the potentially addictive qualities of social networking sites.

Such media coverage has alleged that women are at greater risk than men for developing addictions to SNSs . The mass appeal of social networks on the Internet could potentially be a cause for concern, particularly when attending to the gradually increasing amounts of time people spend online . On the Internet, people engage in a variety of activities some of which may be potentially to be addictive. Rather than becoming addicted to the medium per se, some users may develop an addiction to specific activities they carry out online.

Specifically, Young argues that there are five different types of internet addiction, namely computer addiction (i. e. , computer game addiction), information overload (i. e. , web surfing addiction), net compulsions (i. e. , online gambling or online shopping addiction), cybersexual addiction (i. e. , online pornography or online sex addiction), and cyber-relationship addiction (i. e. , an addiction to online relationships). SNS addiction appears to fall in the last category since the purpose and main motivation to use SNSs is to establish and maintain both on- and offline relationships.

From a clinical psychologist’s perspective, it may be plausible to speak specifically of ‘Facebook Addiction Disorder’ (or more generally ‘SNS Addiction Disorder’) because addiction criteria, such as neglect of personal life, mental preoccupation, escapism, mood modifying experiences, tolerance, and concealing the addictive behavior, appear to be present in some people who use SNSs excessively. Social Networking Sites are virtual communities where users can create individual public profiles, interact with real-life friends, and meet other people based on shared interests.

SNSs are web-based services that allow individuals to: construct a public or semi-public profile within a bounded system, articulate a list of other users with whom they share a connection, and view and traverse their list of connections and those made by others within the system”. The focus is placed on established networks, rather than on networking, which implies the construction of new networks. SNSs offer individuals the possibilities of networking and sharing media content, therefore embracing the main Web 2. attributes, against the framework of their respective structural characteristics. In terms of SNS history, the first social networking site (SixDegrees) was launched in 1997, based on the idea that everybody is linked with everybody else via six degrees of separation, and initially referred to as the “small world problem”. In 2004, the most successful current SNS, Facebook, was established as a closed virtual community for Harvard students. The site expanded very quickly and Facebook currently has more than 500 million users, of whom fifty percent log on to it every day.

Furthermore, the overall time spent on Facebook increased by 56% from 2007 to 2008. This statistic alone indicates the exponential appeal of SNSs and also suggests a reason for a rise in potential SNS addiction. Hypothetically, the appeal of SNSs may be traced back to its reflection of today’s individualist culture. Unlike traditional virtual communities that emerged during the 1990s based on shared interests of their members, social networking sites are egocentric sites. It is the individual rather than the community that is the focus of attention. Egocentrism has been linked to Internet addiction.

Supposedly, the egocentric construction of SNSs may facilitate the engagement in addictive behaviors and may thus serve as a factor that attracts people to using it in a potentially excessive way. This hypothesis is in line with the PACE Framework for the etiology of addiction specificity. Attraction is one of the four key components that may predispose individuals to becoming addicted to specific behaviors or substances rather than specific others. Accordingly, due to their egocentric construction, SNSs allow individuals to present themselves positively that may “raise their spirits” (i. . , enhance their mood state) because it is experienced as pleasurable. This may lead to positive experiences that can potentially cultivate and facilitate learning experiences that drive the development of SNS addiction. A behavioral addiction such as SNS addiction may thus be seen from a biopsychosocial perspective . Just like substance-related addictions, SNS addiction incorporates the experience of the ‘classic’ addiction symptoms, namely mood modification (i. e. , engagement in SNSs leads to a favourable change in emotional states), salience (i. e. behavioral, cognitive, and emotional preoccupation with the SNS usage), tolerance (i. e. , ever increasing use of SNSs over time), withdrawal symptoms (i. e. , experiencing unpleasant physical and emotional symptoms when SNS use is restricted or stopped), conflict (i. e. , interpersonal and intrapsychic problems ensue because of SNS usage), and relapse (i. e. , addicts quickly revert back in their excessive SNS usage after an abstinence period). Moreover, scholars have suggested that a combination of biological, psychological and social factors contributes to the etiology of addictions, that may also hold true for SNS addiction.

From this it follows that SNS addiction shares a common underlying etiological framework with other substance-related and behavioral addictions. However, due to the fact that the engagement in SNSs is different in terms of the actual expression of (Internet) addiction (i. e. , pathological use of social networking sites rather than other Internet applications), the phenomenon appears worthy of individual consideration, particularly when considering the potentially detrimental effects of both substance-related and behavioral addictions on individuals who experience a variety of negative consequences because of their addiction.

Article 2 Title : Facebook Addiction Disorder – The 6 Symptoms of F. A. D. Writer : Amy Summers Source : www. socialtimes. com “Okay, I admit it. I am truly addicted to Facebook,” said teenage blogger Heidi Barry-Rodriquez in 2007. In 2009, teen Neeka Salmasi described the social networking giant as being “like an addiction”. This year, a casino site mentioned that “Facebook provides the atmosphere where it is tough to walk away” in a direct comparison to gambling addiction. A quick web search and it becomes appallingly evident that we have a problem.

Text messaging is no longer the biggest teenage obsession, and long gone are the days where the biggest worries for parents were celebrity crushes, massive phone bills from ridiculously long phone calls and chocolate overloads. These teenage obsessions still exist, but in today’s day and age, and in comparison to the Facebook craze, they seem rather insignificant. Facebook is taking over the world, and that’s no exaggeration. Everyone from eager-to-fit-in teens to educated business people to intrigued grandparents has joined the phenomenon, and unsurprisingly many teenagers have also caught Facebook fever.

And like with many of the latest attention-grabbing trends, some teenagers can go a little overboard when participating in them. Perhaps we join Facebook because everyone has an account and, as teenagers, the need to fit in is just too great, or perhaps there’s just a special something that has helped the social networking site attract so many million people. Teenagers have a tendency to become obsessive with the ‘in’ thing and Facebook, the trend of the decade, is no exception; the question is, have we overdone in? And is there really such thing as Facebook addiction?

An American psychologist believes so. In fact, he’s even introduced a new term to describe such an addiction. FAD, or Facebook Addiction Disorder, is a condition that is defined by hours spent on Facebook, so much time in fact that the healthy balance of the individual’s life is affected. It has been said that approximately 350 million people are suffering from the disorder that is detected through a simple set of six-criteria. People who are victims of the condition must have at least 2-3 of the following criteria during a 6-8 month time period. . Tolerance: This term is used to describe the desperate behavior of a Facebook addict. They spend an increasing amount of time on the site, coming to a stage where they need it in order to obtain satisfaction or on the other extreme, it is having a detrimental effect on them as a person and their life. For the family members and friends who think they are dealing with an addict, a sign to look out for are multiple Facebook windows open. Three or more confirms that they are indeed suffering from this condition. 2.

Withdrawal symptoms: These become obvious when one is restricted from using Facebook because they have to participate in normal everyday activities. Common signs are anxiety, distress and the need to talk about Facebook and what might have been posted on their wall in their absence. 3. Reduction of normal social/recreational activities: Someone suffering from FAD will reduce the time spent catching up with friends, playing sport or whatever it is they used to enjoy doing, to simply spend time on Facebook. Instead of catching up with a friend for coffee, they will send a Facebook message.

A dinner date will be substituted with a messenger chat. In extreme cases, the person will even stop answering their parent’s phone calls, instead insisting that they use Facebook to contact them. 4. Virtual dates: It is obvious that things are extreme when real dates are replaced with virtual dates. Instead of going to the movies or out to dinner, they tell their partner to be online at a certain time. 5. Fake friends: If 8 out of 10 people shown on their Facebook page are complete strangers, it is undeniable: they have a serious case of FAD. 6.

Complete addiction: When they meet new people, they say their name, followed by “I’ll talk to you on Facebook”, or for those who are extremely bad, “I’ll see you in Facebook”. Their pets have Facebook pages, and any notifications, wall posts, inboxes or friend requests that they receive give them a high, one which can be compared to that gambling addicts get from the pokies or roulette table. So someone believes that addiction to the net is a real condition that needs to be treated just like any other addiction, with care and caution, but is an obsession with Facebook a real condition, or is FAD really just the latest fad?

Either way, Facebook obsessions are definitely present in today’s society and whether it is a disorder or not, something needs to be done to fix it. Forget the fancy name and look at the facts. Many people, teenagers in particular, are spending too much time online. People’s lives are being affected because of the hours spent looking at profiles and pictures. Facebook, very beneficial in some ways, is having a detrimental effect on the everyday behaviors of people around the world. Having seen the affects of too much time online firsthand, I know this to be true.

Nobody can possibly disagree when the facts speak for themselves and when an individual’s online ‘life’ becomes more important than their real one; we know that there is a serious problem that needs to be addressed. But, what to do about it? How can we possibly fix a problem that has affected more than a third of the world’s population? That is a question I can’t answer, but I do know that our parents can play an important role, well, that is if the addicted is still young enough to be influenced by their parents. There are two kinds of parents in my area, both from different ends of the spectrum.

On one side we have the Facebook haters; the parents who don’t have Facebook, don’t understand Facebook and never want to understand Facebook. On the other side, we have the Facebook lovers, those who act more like their teenage children than their parents. They’ve befriended their kids online, participate in their online conversations, comment on their photos and send messages from the lounge room to the bedroom instead of just walking up the hallway and keeping matters that should be kept private, well, private. Don’t believe me? I completely understand.

It definitely sounds strange. But the truth is I actually know people like this and well I can only conclude one thing: that these parents, in an attempt to be their teen’s friend rather than their parent, have also been swept up in the Facebook craze and are now suffering from a similar sort of addiction. The apple really does never land far from the tree. REFERENCES 1. http://www. healthism. com/articles/facebook-addiction 2. http://deaddictioncentres. in/news/facebook-de-addiction-social-dysfunction/ 3. http://columbianewsservice. om/2011/02/the-facebook-relapse-trying-to-defriend-facebook/ 4. http://www. sakaaltimes. com/20120418/5754739842191348023. htm 5. http://socialtimes. com/facebook-addiction-disorder-the-6-symptoms-of-f-a-d_b60403 6. http://www. tomsguide. com/us/facebook-twitter-myspace,news-10312. html 7. http://www. netaddiction. com/index. php? option=com_blog&view= 8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders—Text Revision, Fourth Edition; American Psychiatric Association: Washington, DC, USA, 2000 9. Lenhart, A. Social Networking