Diagnosis of Anxiety and Obsessive Compulsive and Related Disorders
Social workers take particular care when diagnosing anxiety due to its similarity to other conditions. In this Discussion, you carefully assess a client with anxiety disorder using the steps of differential diagnosis. You also recommend an intervention for treating the disorder.
To prepare: Read “The Case of Emily P.” Review the decision trees for anxiety and OCD in the Morrison (2014) text and the podcasts on anxiety. Then access the Walden Library and research interventions for anxiety.
Post a 300- to 500-word response in which you address the following:
Explain your own diagnostic decision tree with a brief rationale for any elimination of close differentials for the case of Emily.
Provide the full DSM-5 diagnosis for Emily. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention).
Describe an evidence-based assessment scale that would assist in ongoing validation of your diagnosis.
Recommend a specific intervention and explain why this intervention may be effective in treating Emily. Support your recommendation with references to scholarly resources.
The Case of Emily P.
Emily is a 62-year-old, single, heterosexual, African American female who seeks treatment for anxiety. She says she often hears a female voice directing her to punish herself by tweezing the hair from her head or by scrubbing her home clean. She reported that tweezing her hair eases her anxiety. Emily reports that germs have been a milder but regular concern of hers since adolescence, when she learned in health classes about the risks of serious diseases “like HIV.” Emily presented with meticulous grooming, although the knees of her pants were noted as worn. She has arthritis in her spine and knees and uses a walker to help her manage mobility safely.
Emily receives Social Security income and is not employed. She lives alone in a subsidized apartment in the same building as her 72-year-old, unmarried sister.
Emily and her sister shared an apartment for over 30 years, beginning when each of their marriages dissolved. Emily reported that when her sister began a romantic relationship 5 years ago, Emily began to feel very anxious and started to cry often. Emily moved into an apartment down the hall in the building and began to tweeze the hair from her head, hiding her hair loss by wearing wigs. This behavior occured at different times and resulted in scabbing. Emily said she feels better after but does not always notice how much she is pulling. Her sister learned of Emily’s tweezing after her wig slipped off one evening to reveal bald spots. Her sister encouraged Emily to seek treatment rather than “hiding her ways.” Emily is reliant upon her sister for transportation and for a sense of social and emotional connection. She agreed to this session even though she is pessimistic about anything working.
During our initial visit (at a local mental health center), Emily shared that when she was 2 years old her mother died from tuberculosis, and the following year her father, an army officer, died from colon cancer. After his death, Emily lived with her paternal aunt, from whom she felt no love. Her older brother and sister were placed in an orphanage, and Emily was permitted to see them on Sundays. When it became apparent that the children were entitled to death benefits, Emily’s aunt agreed to take custody of all three siblings. The household then consisted of Emily’s paternal aunt, her husband (who Emily described as an alcoholic), their three children, and Emily and her two older siblings.
Emily was briefly married in her early 20s (4 years) but was disappointed and hurt by her husband’s infidelity. She moved in with her sister at that time. Emily reported it as an “anxious” time but denied tweezing then. Emily also enrolled in a cosmetology school and liked her work. She had to stop working “for health reasons” when she was 58 years old.
When asked what her behaviors are with her hair, Emily reluctantly admitted that if she cannot get to her hair she will pick at a scab or skin. Generally, she avoided social situations so that her behavior is not exposed. She denied other behavior rituals but became noticeably anxious at this question. When asked about “goals” if treatment was to be effective for her, Emily stated that she wanted to “cope better” and to “stop
listening to the punishment voice.” Emily was collaborative during this assessment and engaged after a reluctant start.
Adapted from: Plummer, S.-B., Makris, S., & Brocksen, S. (2013). Social work case studies: Concentration year. Baltimore, MD: Laureate Publishing.
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PSY 638 Final Project Milestone Three Guidelines and Rubric Prompt: Building upon your work for Milestones One and Two, you will submit a draft of the Intervention Strategy and Implementation Plan sections of your grant proposal. Specifically, the following critical elements must be addressed in your milestone assignment:
III. Intervention Strategy: Research and justify the selection of a theoretically supported and effective intervention strategy for addressing the target issue.
a. Efficacy: Analyze and critique at least two established intervention strategies for inconsistencies and effectiveness. i. Critically examine intervention strategies for consistency with current developmental theories. ii. How effective were these strategies in addressing their respective issues? To what extent would these intervention strategies address
the issue identified in your community? b. Selection: Select an intervention strategy and justify your selection based on its effectiveness and the individual, familial,
environmental, cultural, and political factors. Your strategy should be appropriate for your age-specific population. c. Ethics: Analyze the selected intervention strategy for possible ethical and legal challenges. Consider provider as well as client concerns.
IV. Implementation Plan: Construct a plan for implementation of the selected intervention strategy in your community. a. Narrative: Compose a narrative to describe the setting, personnel, target population, length of time for service, and capacity of the
proposed program. b. Training: Formulate a strategy for the training of personnel according to the selected intervention strategy. c. Assessment: Recommend an assessment plan to evaluate the effectiveness of the intervention strategy. d. Ethics: Assess the ethical and legal implications for implementing the intervention strategy in your community.
Guidelines for Submission: Your paper must be submitted as a 6–8 page Microsoft Word document with double spacing, 12-point Times New Roman font, one- inch margins, and at least five sources cited in APA format.
Rubric Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
Intervention Strategy: Efficacy
Submission evidences an extensive review of the current literature to demonstrate consideration of evidence- based intervention strategies for the identified problem/need (considers a minimum of two intervention strategies at a highly detailed level)
Submission evidences a basic review of the current literature to demonstrate consideration of evidence-based intervention strategies for the identified problem/need; submission may consider only a single intervention strategy
Submission evidences a selective or minimal review of the current literature to demonstrate consideration of evidence-based intervention strategies for the identified problem/need, and the submission considers only a single intervention strategy
13
Intervention Strategy: Selection
Submission evidences a clear selection of an intervention strategy based on theoretical and research support considering the age-specific population and community
Submission evidences a clear selection of an intervention strategy that may lack a clear basis in theoretical and research support or it may not clearly consider the age-specific population and community
Submission evidences a selection of an intervention strategy that lacks a clear basis in theoretical and research support, and it fails to clearly consider the age-specific population and community
13
Intervention Strategy: Ethics
Submission provides an extensive review of the ethical and legal implications for using the selected intervention strategy that considers provider as well as client concerns
Submission provides a review of the ethical and legal implications for using the selected intervention strategy that may only consider either provider or client concerns
Submission provides a selective or minimal review of the ethical and legal implications for using the selected intervention strategy, and it only considers either provider or client concerns
13
Implementation Plan: Narrative
Submission presents a detailed narrative to sufficiently describe the setting, personnel, target population, length of time for service, and capacity of the proposed program
Submission presents a narrative that may lack detail to sufficiently describe one or more of the following key components: the setting, personnel, target population, length of time for service, and capacity of the proposed program
Submission presents a narrative that lacks detail to sufficiently describe two or more of the following key components: the setting, personnel, target population, length of time for service, and capacity of the proposed program
13
Implementation Plan: Training
Submission presents a detailed plan that accounts for the training needs of the essential personnel who will supply the services outlined in the intervention strategy
Submission presents a plan that accounts for key training needs of the essential personnel who will supply the services outlined in the intervention strategy; this plan may lack the level of detail necessary to demonstrate full consideration of training needs
Submission lacks a plan that accounts for the training needs of the essential personnel who will supply the services outlined in the intervention strategy, or the plan as presented is minimal for meeting training needs for the selected intervention
13
Implementation Plan:
Assessment
Submission provides a detailed plan for assessing the effectiveness of the program/intervention strategy (an essential component of grant submission that allows for programs to be considered “evidence based”)
Submission provides a general concept for assessing the effectiveness of the program/intervention strategy, yet it may lack clear direction or statistical concepts to meet the goal of the data collection
Submission provides a concept too general for assessing the effectiveness of the program/intervention strategy
13
Implementation Plan: Ethics
Submission evidences a strong assessment of the ethical and legal considerations for implementing the intervention strategy
Submission evidences an assessment of the ethical and legal considerations for implementing the intervention strategy; this may lack attention to one or more elements necessary for a sound ethical approach
Submission provides minimal consideration of the ethical and legal implications; this submission lacks attention to two or more essential elements necessary for a sound ethical approach
13
Articulation of Response
Submission has no major errors related to citations, grammar, spelling, syntax, or organization
Submission has some errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas
Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas
9
Earned Total 100%
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PSYC365 DB Grading Rubric.docx Click for more options (32.043 KB)
In Modules/Weeks 1, 2, 4, and 5 you will participate in the Discussion Board Forums. For each forum, you will post at least 300 words in response to a provided prompt, supporting your assertions with at least 3 citations in proper, current APA format. Required sources are the textbook and a scholarly article (no websites, newspaper articles, etc.), and you must include at least 1 biblical reference with chapter and verse. In addition to your thread, you must also respond to at least 2 classmates, posting replies of at least 150 words each. Refer to the provided rubric to ensure guidelines are followed. You are encouraged to post your thread early, to allow the opportunity to further the topic of discussion.
Topic: Dual-Store Model of Memory
Question/Prompt: Discuss all 3 components of the Dual-Store Model of Memory. Give an example of the development of a piece of information through all 3 structures of your memory according to the Dual-Store Model. At each stage, give the verbal or visual stimulus and the cognitive processing for transferring information between stages. Include clear biblical principles in your response
00SKSK2023-05-27 07:33:002023-05-27 07:33:00Dual-Store Model Of Memory Discussion Board
For this Forum, in your Initial Post you will share with your classmates your observations from your research on Developmental and Personality Psychology as subspecialties and career options. post a 300 word minimum length “Initial Post” in response to the topic requirements
Please be sure to address BOTH subspecialties in your response to each question. Points will be deducted if both subspecialties are not clearly and separately addressed for each question.
1) After researching these areas, do you find them to be career possibilities you are interested in or careers that don’t capture your interest? Why or why not?
2) What is at least one interesting thing you learned about each of the two subspecialties that you did not previously know?
3) Describe a “real-world” application for each of the two subspecialties. How could knowledge gained through the pursuit of each subspecialty help us to understand everyday problems, dilemmas, or situations? Note: your answer does not have to be specific to psychology as a field. Think broadly; psychological principles can apply to many different fields.
READING
WEEK 2 Lesson
Welcome to week two of Professional Careers and Education in Psychology. This week we will be considering 3 fields that look deeply into the concept of “nature versus nurture”. Breakthroughs in technology have increased scientific knowledge in the biological sciences, such as in DNA research, cloning, and stem cell research, help psychological clinicians diagnose and treat patients/clients. Our discussions this week will focus on Biopsychology, Cognitive Neuropsychology, and Clinical Neuropsychology.
Biopsychology is also referred to as physiological psychology, behavioral neuroscience, and psychobiology. Biopsychology combines different areas of neuroscience with psychology to explain the bases of behavior. Some of the areas of neuroscience integrated with psychology is neuroanatomy, neurochemistry, and neuropharmacology. A biopsychologist focused on neuropharmacology would be interested in how drugs impact neural activities.
Another area of interest to biopsychologists is what behaviors result from genetics and social influences. They may also research the influence of hormones and other chemicals impact on behavior. The majority of biopsychologists are researchers and educators, employed by universities, the government, research institutes, and pharmaceutical companies.
Review the YouTube video, “What is Biopsychology with Dr. Laurence Nolan?” www.bing.com/video/search?q=Youtube%2c+whatis+biopsychology&adlt=st
Cognitive neuropsychology is a branch of cognitive psychology. The objective is to understand cognition, from the perspective of the brain. Cognitive neuropsychologists study the brain to understand the neural functions responsible for thinking, memory, attention, and language. Technology has enabled Cognitive Neuropsychologists to observe what occurs in the brain with different functions, such as when someone works a math problem or what areas of the brain are responsible for language, short-term memory, or making decisions. Cognitive Neuropsychology is predominantly research oriented and the clinicians are found in mostly research or educational settings.
Clinical Neuropsychology is the application of biopsychology, within clinical and counseling contexts. Assessments and interventions based on the study of human behavior in relationship to the central nervous system is an integral aspect of Clinical Neuropsychology. Their assessments assist doctors to understand how and why the brain malfunctions, along with identifying the associated behaviors. The more doctors understand about neurological malfunctions, they are more equipped to treat and prevent the malfunctions.
An especially significant task of Clinical Neuropsychologists is developing interventions and treatment strategies to assist clients/patients to make adaptations/changes to regain functioning capabilities for independent living and the optimal quality of life. Employment setting opportunities are similar to other psychologists, in that Clinical Neuropsychologists work in medical facilities, clinics, private practice, education, and the government.
A study completed by the American Academy of Clinical Neuropsychology, in 2011, stated the median salary of neuropsychologists was $94,100, in the United States (http://www.theaacn.org/). The range for starting salaries was $77,500 to $80,700. The more experienced clinicians had much higher salaries. Clinical Neuropsychologists with 11 or more years had a median salary of $130,000; whereas those with 25 years or more had a median salary of $185,000.
Although the majority of lucrative career opportunities in biopsychology and neuropsychology require graduate degrees, there are jobs, which only require a bachelor’s degree. We will discuss several of the jobs available to students with only an undergraduate degree. A few of the career options are science technician, psychiatric technician, and clinical laboratory technician. Students are afforded the opportunity to integrate their knowledge of psychology, with their knowledge and interest in biopsychology. More importantly, many entry-level positions provide “realistic” insight into clinical careers. As a result, an individual can decide if they want to pursue more education, by obtaining a graduate degree.
Science technicians work consists primarily conducting laboratory research. In assisting and conducting research, they are able to combine the principles of science, along with mathematics, to facilitate solving problems in research and development. They work very closely with the researchers and scientists. Their responsibilities include maintaining the laboratory, the operation and maintenance of the equipment, experiment monitors, recording data and observations. Many fields require different kinds of technicians and professional titles are assigned based on the specific field, such as agricultural technician or forensic science technician.
The job opportunities for science technicians are robust and steady through 2018, according to the Bureau of Labor Statistics, 2010. The median salary for biological technicians, in 2008, working in government settings was $39,538 and physical science technicians in government settings earned a median salary of $55,527 (Bureau of Labor Statistics, 2010).
The work of a psychiatric technician is dynamic and varied. Their responsibilities are helping the psychiatrist or other mental health clinicians care for mentally ill and emotionally challenged patients/clients. Some of their specific responsibilities include the following: following the clinician’s and hospital/facility’s processes; observing and documenting the patient/client’s emotional and physical status; keeping the clinical staff updated; providing therapeutic services, and medication administration. When compared with the salary ranges for other healthcare professionals, psychiatric technicians are not compensated, as well. An entry-level psychiatric technician salary is around $27, 865 (Bureau of Labor Statistics)
Students with interests in biopsychology can work in clinical laboratories, as clinical laboratory technicians of clinical laboratory technologists. Their main job function is analyzing physical samples of patients. The work they do result in detecting, diagnosing, and treating diseases. The salary range for clinical laboratory technicians is $53, 500 yearly, according to the Bureau of Labor Statistics, 2010.
To access summary information about Neurological and Biological psychology, two closely related sub-specialties with the field of psychology, and the study of Perception, click on these links:
Brain science and cognitive psychology focuses on how individuals learn, process and store information.
All About Brain Science and Cognition
When you meet new people, why do you remember some names but not others? This is an example of a question that psychologists working in brain science and cognition seek to answer through their research.
These psychologists spend most of their time studying human thought processes and the capacity for understanding, interpreting and retaining information. They may choose to work in one particular specialty, such as memory or learning disabilities, or they may focus their career on a specific health issue or population.
Psychologists working in this field apply psychological science to address a wide variety of issues that affect a spectrum of populations. They work with infants and toddlers to address behavioral problems and developmental disorders. They work with adults to address memory disorders, substance use and health-related problems. Others study the brain’s capacity to do tasks, handle multiple demands or recover from injury.
In their work, many of these psychologists will drill down into intricacies such as how music therapy can help heal degenerative brain disorders or how quickly humans can learn a new language. Some study how the brain interprets smells. Others are working to decode the human brain.
What You Can Do
Most psychologists working in brain science and cognition spend their careers in a university setting where they teach or conduct research or both. However, there has been significant growth in other areas, such as human-computer interaction, software development and organizational psychology. This growth has opened new job opportunities in the private sector.
Cognitive psychologists can also work in clinical settings to help treat issues related to human mental processes, including Alzheimer’s disease, speech issues, memory loss, and sensory or perception difficulties. These psychologists will often work in government and private research centers and treatment facilities, such as hospitals and mental health clinics, and as consultants or expert witnesses for court cases. Private practice is also an option for psychologists working in this field.
Making It Happen
While there are some entry-level opportunities available to those with a bachelor’s degree, most careers in brain science and cognitive psychology begin with a master’s or doctoral degree.
For psychologists with a master’s degree, career options exist in human performance research, such as testing how well a person who has not slept for many hours can remember a short story. They may also work in industrial and organizational psychology, and some with master’s degrees may be hired for certain teaching positions. Most of the work of master’s level professionals will be supervised by a doctoral level psychologist.
Most psychologists with doctoral degrees in brain science and cognition teach and conduct research in academia.
What You Can Earn
The earnings for psychologists working in brain science and cognition vary based on degree, position and experience. According to the U.S. Department of Labor, brain science and cognitive psychologists working as industrial and organizational psychologists earned more than $114,040 a year on average with a median annual salary of $87,330 in 2010. The American Psychological Association found that median annual salaries for brain science and cognitive psychologists employed at universities averaged $76,090 in 2009.
While demand for brain science and cognitive psychologists has fluctuated, the subfield is on the rise. As technology becomes more advanced and cures to health issues like Alzheimer’s disease continue to be evasive, the demand for psychologists specializing in brain science and cognition is expected to increase.
Helpful Resources
Clinical Neuroscience
APA Division 40 was established to study brain-behavior relationships and the clinical application of that knowledge to human problems.
Clinical Neuroscience is a recognized specialty in professional psychology.
Behavioral and Cognitive Psychology
Behavioral and cognitive psychology uses the principles of human learning and development and theories of cognitive processing to understand how the brain works, rests and recovers.
Behavioral and Cognitive Psychology is a recognized speciality in professional psychology.
Physiological psychologists study the relationship between behavior and biology. They try to understand psychological states in terms of brain chemistry and the nervous system. Physiological psychologists conduct experiments on animals to determine the biological basis of behaviors. They use the data they obtain from these experiments to answer questions about human psychology.
Experimentation
Physiological psychologists are particularly interested in the endocrine system, which controls the hormones that govern or influence both emotions and actions. By studying how animals respond to different stimuli and how changes in the endocrine system or in brain structure affect different aspects of their behavior, they hope to better understand similar processes in human beings. Physiological psychologists attempt to understand the complexity of human psychology by studying the simpler chemical and electrical processes that underlie it.
Controversy
Physiological psychologists justify the practice of animal experimentation by pointing to its possible benefits to human health and quality of life. Experiments conducted on animals by physiological psychologists have led to advances in the understanding of strokes, schizophrenia, anorexia, Parkinson’s disease, manic-depressive disorder, obsessive-compulsive disorder and other anxiety disorders. Because many of these advances occurred incidentally while conducting unrelated research, physiological psychologists argue that they should be free to conduct animal experiments without restriction.
Employment
Many physiological psychologists work for colleges or universities, where they are expected to both teach and conduct new research. For example, a physiological psychologist at the Department of Psychological and Brain Sciences at Johns Hopkins University discovered that aging rats showed signs of cognitive decay similar to that found in aging humans, but without the expected loss of functioning brain cells. Her research found that some areas of their brains were actually hyperactive, rather than underactive, so she treated them with valproate to reduce activity in that area of the brain. If this treatment proves effective, it may offer a new approach to the treatment of dementia.
Education and Research
Some physiological psychologists work for government or private research laboratories, and some work for pharmaceutical companies. Whether they work for a university or a private employer, physiological psychologists must have a doctorate and usually a few years of post-doctoral work under an established researcher. Physiological psychology is a branch of neuroscience, and physiological psychologists may also be described as psychobiologists, biopsychologists or behavioral neuroscientists. Research in this field is published in academic journals such as the “Journal of Neuroscience” and “Pharmacology, Biochemistry and Behavior.”
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