Again, keeper studies can be identified using handy Rapid Critical Appraisal checklists consisting of a set of simple but important questions. Below are sample questions developed for use with quantitative studies that are applicable to most appraisal situations (its important to note that qualitative evidence, if its relevant to the clinical question, should not be dismissed):

1. Why was the study done? Make sure the study is directly relevant to the clinical question.

2. What is the sample size? Size can and should vary according to the nature of the study. Since determining a valid minimum sample size in a single study can be difficult, taking into account multiple studies is beneficial.
The answer to this question alone should not remove a study from the appraisal process.

3. Are instruments of the variables in the study clearly defined and reliable? Make sure the variables were consistently applied throughout the study and that they measured what the researchers said they were going to measure.
4. How was the data analyzed?
Make sure that any statistics are relevant to the clinical question.

5. Were there any unusual events during the study? If the sample size changed, for example, determine whether that has ramifications if you wish to replicate the study.

6. How do the results fit in with previous research in this area? Make sure the study builds on other studies of a similar nature.

7. What are the implications of the research for clinical practice? Ask whether the study addresses a relevant and important clinical issue.

Use the website for the article to answer the above 7 questions: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414128/

Juan and Bianca are a middle-aged couple of Latino descent. The couple has two children, both away at college. Juan and Bianca were referred by their priest for counseling, due to Biancas history of depression and suicidal ideation. Bianca tells you, life has always been a struggle for me. I was raised by my grandmother who tried to protect me, but I was molested many times as a little girl. Ive often wanted to end my life, but my religious beliefs dont allow me to.  Bianca does report periods of joy and happiness in her life, especially regarding her children. She admits that during the last 5 years, she has had a few periods where she has actually felt euphoric, energized and elated with life. These times are brief and infrequent and, I return to that suffocating place of despair. She describes her husband as, a good man. I dont know why he has stayed with me all these years.  Juan is very supportive of his wife, but his worry about her has resulted in exhaustion, missing work and obsessively checking that all the kitchen knives are accounted for. He tells you that, sometimes Bianca cries out in her sleep and I dont know how to help her.  I worry that she will do something to end her life during one of these night terrors. Even though shes never tried, what if it happens and Im not able to stop her.

Directions: Consider Mood, Anxiety, OCD, and Trauma Related Disorders

1.  Taking into account the genetic, neurobiological, sociocultural, familial and environmental factors of assessment and diagnosis, what are your diagnostic thoughts for Bianca? What about Juan? Use the DSM-5 criteria to formulate your diagnostic impressions for Bianca and Juan, supporting what you see in the vignette that supports your diagnostic impressions.

2.  Using the psychotherapeutic and pharmacological interventions discussed in the text, describe an initial treatment plan for Bianca and Juan. Remember to treat the persons in the vignette, and not the diagnosis. Also remember to consider culture and legal/ethical issues.

3.  Given the diagnosis you have made, describe your medication treatment strategies. Discuss not only initial choices of medications but also your next-step strategy and why youve chosen it. (In doing so, be sure to provide a rationale for your choices.) What questions should be addressed about the class of medications that is chosen (e.g., mood stabilizers)?