Individual Differences and Abnormal Psychology - Assignment Example

Running Head: INDIVIDUAL DIFFERENCES Individual Differences and Abnormal Psychology Individual Differencesand Abnormal Psychology 1. What are the advantages and disadvantages of using classification systems in abnormal psychology? Using a classification system in any field of psychology is always a slippery slope. There are certain benefits to diagnostic criteria in a classification system that can lead the therapist down the correct road to diagnosis, but then there is always the pitfall of making the symptoms fit the criteria and creating an improper diagnosis that fits the classification. In general the most broadly used classification system used by psychologist in general and abnormal psychologist in particular is the medical model as created by the DSMV IV (Carr, 2001). This system has the advantage of being easily understood across a wide spectrum of disciplines both medical, neuropsychological and psychological. This system also allows therapist to have some guideline to prediction of stages, treatment and care planning after the diagnosis has been categorized. In this model it is assumed that the various abnormal behaviors that people with a particular syndrome display are symptoms of a specific disease with a discrete cause, a unique course and prognosis, and for which a specific physical treatment will ultimately be identified. (Carr, 2001, p. 178) The DSMV IV has a distinct advantage over the previous medical models in that it uses a Multiaxial system regarding diagnosis of mental disorders. This at least allow a wider range of criteria to be assessed and a broader spectrum of treatment and diagnosis become available. The fives axis are: Clinical Syndrome, which contain major classification such as schizophrenia, etc.; Personality disorders such as antisocial, attachment, etc.; Physical disorder; Psychosocial stressor such as environmental, familial concerns; and a Global Assessment of the overall level of function of the patient (Carr, 2001). While the medical model has prevailed there have been attempts to use other systems to assist in the categorization of features in abnormal psychology. Unfortunately only one has been useful in helping to develop the Multiaxial Model now in place in the DSMV IV and this is the Dimensional model. This model would take into account certain nuances that the strict categorization model may miss and is more dependent on individual and personal histories of the patient rather than a set of exact criteria. Another singular advantage of using the Medical Model is that it is readily accepted and understood by most insurance providers. This, above most other motivations, has proven to be the system by which psychologist and psychiatrist are at least allowed to bill for their services using insurance. It is hoped that most diagnosis do not completely depend on this and the only the broadest application of insurance to treatment is used. Which brings us to the disadvantages of the classification systems. (Speece, 1995). The single most destructive disadvantage of any classification system, especially in regards to human behavior and in particular, metal illness the is idea labeling someone. Labeling, while clinically necessary at times, can often become a form of stereotyping and can be detrimental to both the doctor and the patient. The doctor may suddenly develop tunnel vision in regards to the treatment of the patient, seeing only an obsessive-compulsive disorder or a bi-polar personality and choosing to channel any behavior the patient exhibits into those categories. The Patient may also be stigmatized by labeling him or herself as psychotic, etc. causing them to fall deeper into that syndrome and trusting themselves less an less over time. Society at large also stigmatizes the individual and react differently to them once their diagnostic label is made public. There is also research that has shown the many of the classification systems used are highly unreliable when it comes to abnormal psychology. This is due to both the system itself and the misapplication of diagnostic criteria performed by the doctor. There have been many instances where the different systems of classification were incorrectly associated with the disorder that was represented by the diagnosis. Previously conducted classification studies with school-identified samples can provide only the most general markers with respect to possible subtypes. An unselected sample of children was used to identify learning disabled subtypes for further study. This example underlines a key issue: The results identify multivariate independent variables (i.e., subtypes) and are not an end unto themselves. (Speece, 1995, p. 37) There are also instances where the same categories and diagnostic criteria were found in several other classifications, causing confusion over which classification should b applied to the particular diagnosis. References Carr, A. (2001). Abnormal Psychology. Philadelphia: Psychology Press Speece, D. L. (1995). Cluster Analysis in Perspective. Exceptionality, 5(1), 31-44 3. Compare the different treatments that have been used for anorexia nervosa. What treatments have been shown to be most effective? In general there are four methods that have been used to treat eating disorders such as anorexia nervosa. They are psychotherapy, medication, hospitalization and family/support groups. While there are many other treatments, such as herbal and self help, these four have had the most relevant results and are recommended by medical and psychiatric professionals. But to begin with it is necessary to fit the treatment to the onset of the disease and the cadre affected by this disease. Anorexia Nervosa affects approximately one to five percent of the population and of that approximately ninety-five percent of those affected are women between the ages of twelve and thirty-five. Although the disease can be found in most racial backgrounds it is prevalent among white middle to upper class females (Smolak, Levine, and Striegel-Moore, 1996). There may also be other biological factors that may be contributory to this disorder. The transition period of adolescence is a time of upheaval both emotionally and hormonally for the growing adult. These changes create psychological imbalances in the mind that may easily find their way into certain behavioral patterns that can contribute to the onset of anorexia nervosa. Whereas passage into adolescence appears to be the stage of transition associated with the highest risk for developing AN [Anorexia Nervosa], the movement out of adolescence and into adulthood is associated with the highest rates of onset of BN [Bulimia Nervosa] and BED [Binge Eating Disorder]" (Smolak, Levine, and Striegel-Moore, 1996, p. 366) However, there are drawbacks to all of the above mentioned treatments. To date there has not been a through analysis of psychoanalytic techniques and in many ways they have proven ineffective in dealing with this disorder on their own. This is especially true of the younger adult whose psyche is in flux and may not respond consistently to therapy sessions. There are many other variables to consider when treating cases of anorexia nervosa or any eating disorder with psychological therapies, such as which school of psychoanalysis fits best, what form and length of delivery and so on. In patient hospitalization can certainly have an immediate beneficial effect on the patient. But while hospitalization may restore the patient’s weight by force-feeding, such an intervention does not bode well for long-term recovery and most patients that do not have follow up counseling usually fall back into the syndrome. This is why clinical interventions in use such as outpatient treatments seem to have a more lasting effect. There have been some medications that have also proven effective such as flueoxetine (Smolak, Levine, and Striegel-Moore 368) The drawback with a medication only treatment is that it become the patient’s choice to take the drug and without other intervention the anorexic behavior usually makes the aptinet stop takig the drug. Family support groups seem to have had the most long lasting success rate of any of these treatments where, “the age of onset of AN has been 18 years or less and the duration of illness has been less than three years” (Smolak, Levine, and Striegel-Moore, 1996, p. 368). By continuous ongoing support, family and peer intervention becomes a valuable tool in fighting this disorder. There is also more data that strongly indicate the earlier the disease is caught the higher the success rate of any treatment. Levitt and Sansone evaluate a community based treatment program called EDP (Eating Disorder program) that is a combination of both in and out patient treatment, group therapy, and psychoanalysis. Patients are evaluated on an individual basis and over a broad range of criteria: The EDP views clients symptoms as learned behaviors that are maintained by multiple psychological, social, familial, and biological factors; all intertwined within a culture that reinforces many of the values of these clients such as fear of fatness, intense focus on dieting and weight loss, the belief that improved self-esteem can be obtained through weight loss, and so forth. (Levitt, and Sansone) One thing became clear in researching an appropriate answer to this question, no one treatment alone seems to be successful. Each case, depending on the psychological profile and duration after onset, is unique and requires a combination of therapies. One treatment oes seem to be essential to long term success in the treatment of anorexia nervosa. Some type of group therapy needs to be in place, either family or peers, in order for nay other treatment to be effective. Although clients can be initially hesitant to participate in a group, the relief that many clients experience when they realize that they are not alone with this issue is often palpable…Once trust and safety have been established, clients are typically able to begin to explore file sociopolitical, interpersonal, family, and individual factors that contribute to their eating disorders. (Huebner, Weitzman, Mountain, Nelson, Oakley & Smith, 2006) References: Huebner, L. A., Weitzman, L. M., Mountain, L. M., Nelson, K. L., Oakley, D. R., & Smith, M. L. (2006). Development and Use of an Eating Disorder Assessment and Treatment Protocol. Journal of College Counseling, 9(1), 72-78. Levitt, J. L., & Sansone, R. A. (2003). The Treatment of Eating Disorder Clients in a Community-Based Partial Hospitalization Program. Journal of Mental Health Counseling, 25(2), 140 Smolak, L., Levine, M. P., & Striegel-Moore, R. (Eds.). (1996). The Developmental Psychopathology of Eating Disorders Implications for Research, Prevention, and Treatment. Mahwah, N.J.: Lawrence Erlbaum Associates. 4. Is depression and anxiety common among the elderly? Discuss the appropriateness and effectiveness of treatments for these conditions in the elderly population. Certainly there is some concern for depression and despair in the elderly in America. But now in this new century we must look at whom we are considering elderly. While sixty-five used to be the cut off point between a productive citizen and senior citizen this is no longer the case. Many adults carry on an active life and even have second and third careers well into their seventies and eighties and beyond. Yet some do not. Those who either have not had the same ambitions or supports, or who have fallen ill may not find the satisfaction of continuing to explore life and contribute and have pride in their own existence.. This cohort, many relegated to long term care facilities for one reason or another, certainly comprise a potentially depressed elder population. Erik Erikson in his book, The Life Cycle Completed / Extended Version, (1997) created several categories and ages in the life cycle of human beings. He associated psycho-social modalities with nine ages of man, from birth to extreme old age. In his study he noted that between the ages of sixty-five and eighty, the category of late adulthood the psycho-social crisis was finding the balance between integrity and despair. If the adult went into this phase in complete possession of his or her faculties both mentally and physically, then there was a chance to maintain their integrity. However, there is also an increased need for intimacy in order to replace the possible loss of the frequency of sexual relations. Success or failure here often can also result in depression. Furthermore, from the age of eighty and beyond, a further reduction in faculties and the possible onset of Alzheimer’s disease can certainly produce despair and depression. Early in the disorder, people with Alzheimers disease are able to perceive their cognitive loss, which adds to the emotional devastation of this disorder. To support a diagnosis of Alzheimers disease, cognitive impairments must be severe enough to impair self-maintenance, employment, and social functioning. Personality and social behaviors may be maintained well into the disease, and certain habits may also remain intact for some time. (Keough & Huebner, 2000) There are physical and psychological burdens that simultaneously affect both the elder family member and the caregiver. “Primary and secondary burdens or stressors also affect the caregiver. Primary burdens are stressors caused directly by the limits of the patient; secondary burdens are stressors caused by the caregiver role” (Keough & Huebner, 2000, p. 37). In a study conducted by Serrano, Latorre, Gatz, and Montanes, they researched a nursing home population of adults suffering from depression and implemented a life review process. The life review process involves emotional processing of events from the individuals past. They implemented an autobiographical retrieval practice that focused on recalling specific events that these older adults might not have reviewed on their own. The results showed that older adults who received this practice improved their depressive mood states with decreased depressive symptoms and feelings of hopelessness. This practice also improved their life satisfaction ratings as, compared with a control group, who did not show any changes in their mood state. (Serrano, et al, 2004) In general the approach would follow the lines of reasoning which the study by Serrano et al has established “…the approach that we took to life review was to provide practice for participants in producing specific autobiographical memories. If participants produced specific memories, we theorized, then the types of rumination that maintain depression should be reduced.” (Serrano, et al, 2004, p. 276) Their prediction, that corroborated by the study results was, “…that older adults who received practice would improve their mood state, as reflected in decreased depressive symptoms, decreased hopelessness, and increased life satisfaction” (Serrano, et al, 2004, p. 276). There are also the usual myriad array of anti-depressants and other medications, many of which may be contra-indicated in the elder patient due to various issues such as drug interaction and poor tolerance to the medications side effects. In fact, many of the medications, such as heart or blood pressure prescriptions, may actually induce depressive side effects and a thorough examination and global history of the elderly patient is necessary before prescribing any medication. However, after ameliorating any medical conditions that may cause depression, group therapy and work therapy have been found very beneficial in alleviating further signs of depression amongst the elderly population. References Erikson, E. H. & Erikson, J. M (1997) The life cycle completed / Extended version. New York : W.W. Norton. Keough, J. and Huebner, R.A (July 2000). Treating dementia: the complementing team approach of occupational therapy and psychology..: Journal of Psychology;Vol. 134 Issue 4, p375 Serrano, J.P. ,Latorre J.M., Gatz M., Montanes, M.J. (2004) Life review therapy using autobiographical retrieval practice for older adults with depressive symptomatology. Psychology and Aging. Vol. 19 (2) J pp. 272-277. Read More