Learning Assessment—Final

The multidimensional approach we learned in one of the first few chapters is, in my opinion, one of the biggest, most critical concepts that we used in this course and a concept that really applies to the field of psychology as a whole. I wrote about it in my first learning assessment and still feel that it is a critical piece of the ‘take home message’ for this class. When thinking about the causes, diagnosis and treatment for an individual, the multidimensional approach is the answer! Looking at multiple factors that could have contributed to the development of the disorder and recognizing that it is probably going to have many factors involved is important because different causes may need different treatments and it is also extremely helpful when searching for ways to prevent the disorder. Also, this concept is really the foundation for other concepts like the diathesis-stress model and reciprocal-gene model which recognize that there are multiple causes for disorders and explain how those factors working together can lead to the symptoms of a disorder.

Some things from the current unit that really shocked me and I feel are worthy of ‘most influential’ were 1.) that an individual with a ‘mental illness’ is only just as likely to be violent as a ‘normal’ person, not more likely, and 2.) that the insanity defense is only successful less than 1% of the time. Both of these things are not adequately portrayed in the media.

In horror films, the person that is committing all of the violent acts is often also implied as having a mental dysfunction of some kind. Usually, the disorder isn’t specifically stated but it is usually clear that they are psychologically impaired. Some films that come to mind are Halloween, Psycho and The Butterfly Effect. It’s really easy to see why people would believe that people with a mental illness would be more likely to commit a crime or ‘go crazy’ than a ‘normal’ person because like others, I had assumed that individuals with mental illness were more likely to commit violent crimes because of the movies that I’ve seen and because I had never questioned the matter or been told otherwise.

The insanity defense was something that really surprised me because I witnessed several negative conversations about it prior to this course especially among my family and family friends in my hometown. Most of the time the conversation would come up after a breaking news story about someone who was pleading insane. Now that I know this information, I can inform others about the misconception they’ve fallen prey to. Overall, these two things have further emphasized that I shouldn’t make assumptions but should question and research to find out if the stereotypical ideas and information that I’ve always accepted to be true really is. I believe that this don’t only apply to abnormal behavior but applies to many other things in life as well. It’s something that I need to constantly keep in the back of my mind to pull out when I see or hear something and I’m not necessarily sure the evidence behind it.

My biggest piece of advice to future students is DON’T take it for granted if you do well on the first exam or any exam for that matter. I did well on the first exam and thought that future exams were going to be as easy and require the same amount of studying as that one. Because of that, I started making the readings my last priority and ended up doing poorly on the following exam. PLEASE do not do that! It will hurt your understanding of the material and your grade.

Second, be sure to read the entire syllabus! I didn’t read the part in the syllabus that said we were tested over the current two chapters AND the previous two chapters until the third exam which really hurt me when I took the second one because I had forgotten some of the material that we covered in the first unit.

Last, go to class! It only meets twice a week and during the meeting times you will discuss concepts that are likely to be on exam. I didn’t miss and I feel that if I had it would have hurt my understanding of the material that we were covering and I could have potentially missed a quiz or an in class assignment which are both worth points and are both unannounced.

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Case Study #4

Chronic Schizophrenia: The Case of Lenny D.

1. Steve was co-editor of his school newspaper, played and lettered on his high school football and track teams, made high grades in school and was president of his senior class. Basically, while in high school, he was the epitome of success. He also got into a really good college, which is where is problems started.

Lenny on the other hand was always rowdy and rambunctious, even in early childhood. While in high school, he skipped school a lot, failed eleventh grade, drank, smoked pot and lied frequently. After he dropped out of school, he went through a substantial amount of jobs which all ended in being fired.

Out of the two, Steve definitely has an advantage during recovery. First, he didn’t do drugs, particularly marijuana and Lenny did. Marijuana worsens the symptoms of schizophrenia. (Source: http://www.livescience.com/10700-marijuana-worsens-schizophrenia.html and the textbook)

Lenny’s rebellious attitude will hinder him during recovery because he’ll be more reluctant to taking his medication or attending therapy when he supposed to and will definitely be more likely to quit doing either. Since Steve has been compliant throughout his life, he will probably do his best to take the medications and go to therapy or do any other treatment that the doctor recommends.

The one advantage that Lenny does have is his family’s support. Although, it says in the case that he spent a lot of his time in the hospital, his parents still play an important role in his recovery and while he was home, they definitely had an impact. Lenny’s family was large and tight knit. The only family support that Steve has is his stepmother and possibly his siblings.

2. I’m sure I would spend the better part of my teens frustrated. I would probably be frustrated with him, his illness and the lack of attention from my parents because they were spending their time and finances trying to help him. BUT, as I grew older and learned more about the disorder, I’m sure that many of my feelings would change because I would begin to understand that a lot of the things that he did and the pain that he caused was illness-related and that he was really sick during those times. I could also see myself becoming passionate about the illness and wanting to make a career out of it.

Right now, I have plans to travel and live pretty far away from home for awhile once I have an established career. My plans might be different if he wasn’t hospitalized because I would feel like I needed to help my parents with the responsibility of getting him places and playing that supportive role. I may have not even decided to go to college a couple of hours away depending on the severity of the case and how much help my parents needed.

I think I would also be somewhat more humbled/down to Earth. I don’t think I would take the abilities that I have like being able to have a sensible conversation, think through a math problem and know the ‘reality’ of my surroundings at all time for granted like I so often do. I would consistently be reminded that not everyone has those abilities. BUT, I would also be questioning, ‘Why?’ What caused him to be this way and what is the optimum situation for him where he can have the best quality of life?

3. Gaining understanding of the disorder was the biggest step for them, in my opinion, before they began to change their behavior. As they began to understand more about the disorder and realize that they weren’t the only ones with a child that had schizophrenia, they began to be able to deal with it better. Also, by the time they started understanding schizophrenia, Lenny had started seeking treatment and so his symptoms were probably getting better.

Another thing that probably caused them to change is their understanding of their role. At first, they didn’t have an understanding of schizophrenia and Lenny’s father was reluctant to believe that Lenny really had a condition. But, over time, he began to accept and realize that he did. After that, both parents seemed to want to play a more active role in the healing process for Lenny. With that, they gave in to his pleas to come home where his symptoms would begin to strength again until they would have to send him back again. After the happening several times, they gained the understanding that he was going to ‘get better.’ He would need assistance of some kind all of his life and they also learned that they didn’t have to be that assistance. He could gain more from being in an assisted living community rather than in their care.

Overall, they were scared and hesitant to accept his diagnosis in the beginning. As they gained some understanding of it, they wanted to be there to help him ‘get better,’ and once they realized that his condition was chronic, they made the decision not to take him back into there care. It was really a big learning process for them as I feel that it is for any parent dealing with chronic/impairing conditions.

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Case #44

1. The evidence that suggests that Megan’s mom may have problems similar to hers is that she has had multiple partners, she was a ‘pothead’, she forgets to check and sign Megan’s sheet, she is currently laid off and attempting to start her own business while also attempting to get published as a children’s book author and she has been seeing a therapist off and on for quite some time to help her with “depression” and “finding a direction in life”. All of these things show that she has a hard time staying focused on a particular task or goal. Her “depression” may be partially caused by the fact that she is unable to stay focused on her life goals and feels there is too much instability in her life especially since the problems with her daughter arose.

One of the sets of questions that I would ask in order to assess whether Megan’s mom could potentially be given a similar diagnosis is, “What were your experiences in elementary and middle school like? Did you maintain good grades? Did you enjoy your classes and feel engaged? What about at home? What did your room look like? What were some of your interests?” I would ask these questions in order to find out if she had difficulty focusing in school and at home and to what extent and for how long she had those difficulties since ADHD has to have at least some symptoms before the age of 7 and for at least 6 months.

I would also ask her what she thinks is causing her “depression” and why she isn’t satisfied with her “direction in life.” I would ask her these questions in order to find out if what she is being given therapy for may be caused by her lack of attention, inability to focus or inconsistency. She may not be as successful as she would like to be at her job and in her relationships with others because of her difficulties paying attention or inconsistent task fulfillment.

Lastly, I would ask her about her job history. How many jobs has she had and why did she leave her previous ones? These questions focus on the inattention aspect if she has inattentive ADHD. If she has been at all of her jobs a short amount of time and was fired because of her inability to complete to task sin a timely manner, she is definitely a candidate for the disorder.

If Mrs. D was diagnosed with ADHD, I would try to change the treatment that Megan is undergoing in order to make it more self-initiated or teacher-mediated because one downfall of her treatment is that it is relying on her mother to consistently check and follow through with her responsibilities. Without this aspect of the treatment, I would imagine that the treatment is much less effective. Also, I would begin some kind of treatment for the mother. I might try to get the boyfriend involved and aware of her condition so that he is able to help her learn how to more effectively deal with the obstacles this disorder poses by pushing her to push herself and push Megan. It could also be a system where Megan and the mom ‘check’ each other to make sure each has been following through on their goals. It would give Megan a sense of power over part of the situation and would provide more support for the mother.

2. If she learns how to discipline herself, they are definitely attainable goals but it would take work especially when memorizing the material for the act or show. But getting to be creative and sometimes getting to make her own schedule would be a plus. Also, the contracts in these fields are usually pretty short term so she could make adjusts and change her mind frequently if she wanted to.

Another good career path is to be self-employed. Like in Megan’s case, people with ADHD often have certain topics that really interest them. If they are able to make a career/business out of that interest then they’ll be set because they don’t to have to abide by anyone else’s schedule or rules. They get to make their own.

Here are some links that I found that also have suggestions on careers for individuals with ADHD:

http://www.everydayhealth.com/adhd-pictures/best-careers-for-adults-with-adhd-0316.aspx#/slide-9
http://whatisadd.net/480/the-best-jobs-for-adhd-adults/

Basically, these websites say that those who have ADD or ADHD should find something that interests them and go from there. They’ll be much more successful because they won’t get bored and tired of it if they are really engaging in and enjoying what they do.

Career paths where an individual might not be the most successful is in careers that have a lot of deadlines such as journalism, editing and directing. Also working in a position where they are responsible for a lot of important or confidential paperwork could be tough if they have a hard time keeping up with things.

3. A school designed to tailor ADHD would have lots of ‘checks’. First, students would have folders to keep their homework in. They are responsible for the folders BUT since they’re likely to lose them, their parents would also receive daily e-mails from the teachers letting them know what the homework assignments for that day are and having the assignments attached in case the folders are lost. Also, the material covered would be up to the child, within certain limits. Although the child would still have to take every subject area, the children, as a class, could decide what specific pieces they cover or at least be given options for how the material will be covered. Also, there would be a clear rewards system similar to what is in public schools now. If children return their homework, folder, etc. they’ll receive a star or bucks or something that they’ll get to cash in later. Also, I think it is necessary to give the children individual time daily to get organized. Maybe 10 minutes in the morning and 10-20 minutes in the afternoon to get all their assignments written down, their papers in order and their mind focused on the goals that they need to accomplish. Also, during in class time, children will be encouraged to work at completing well-defined goals and teachers will be discouraged from frequent lecturing in order to help keep the children engaged. Another option is giving them a list of possible assignments and letting them choose a certain amount that they would prefer to do and letting that being their workload for the day/week/class period. Lastly, an important factor would be shorter class times. Maybe 25-30 minute classes instead of 50-60 minute ones so that they hopefully stay engaged the entirety of the class.

I believe that children with normal attention abilities would do fine at this type of school. If they were able to choose what they got to do, I’m sure they’d really like it. They would also like getting rewarded for doing well because they probably would since they’re less likely to struggle with organization and time restraints. The only thing that they might struggle with is feeling like they’re being ‘babyed’ because they would have to check in with their parents and teachers so much. I know that from personal experience I was always annoyed when teachers treated me like I was irresponsible because I felt that I was more capable and deserved more independence and trust than I was given. Other than that, I feel that they would do fine if not better!

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Learning Assessment #3

I think that the material we are going to learn in the next unit will change my understandings of abnormal behavior because I’m pretty much clueless about personality disorders. I was just flipping through the chapter to see what exactly that might mean and I saw what some of the disorders/stages were. I hadn’t heard of any of them. The only personality disorder I have ever known anything about is split personality. As I briefly skimmed, I didn’t see anything about it. So, for the personality section of this unit everything will be completely new or at least have new terminology that I can use for things that I already knew. For the second section of the unit, I feel that I am fairly familiar  with the disorders that fall under these categories. I skimmed this section as well and saw disorders/conditions like dementia, autism and ADHD. I at least know something about all of those and for some of them, I know quite a bit. It seems that this section has disorders that are more commonplace or the public has an awareness of them.

Autism and down syndrome are definitely the two areas that will pique my interest the most. I’ve been passionate about autism since I became best friends with Raissa in the seventh grade. Her older brother has low-functioning autism and I was around him a lot when I went to her house. Later on, a class that I was in assigned a research project where we had to read three books focused on a specific topic and write an essay about them. My books focused on autism. That’s when I really developed an interest in it. The spectrum of people that are autistic as well as their abilities amaze me. It’s really interesting to me. Along with that, I have known a couple of people who have down syndrome and that disorder has also interested me quite a bit.

I think the area that least interests me is dementia because from what I know so far, that is really a disorder that comes with old age especially when certain preventative steps aren’t taken to reduce the risk of developing the disorder. It also seems that the causes, prevention and treatment are pretty predictable which makes it much less interesting than the other areas that we will be discussing.

I believe that continuing to do the reading, studying over it with a partner and making flashcards are still going to be the most beneficial things for me to do in order to be successful on the test. My goal for the next exam is to spend more time with the material than I have in the past and especially to study the causes, prevention and treatment of each disorder. Also, I need to consider multiple cases and even watch videos that put the disorders into more real terms for me if we don’t do that in class. Hopefully these changes will allow me to improve my understanding of the content and my exam grades!

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DSM-V Article

http://www.psychologytoday.com/blog/the-shrink-tank/201002/dsm-v-offers-new-criteria-personality-disorders

An article I found that will be helpful in learning the personality disorders that are being considered for removal from DSM-V. Hope it helps!

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Case Study #2

1. When reading this  question, I wasn’t quite sure what an asylum was although I have heard the term many times and felt like I had a decent grasp of what the term meant, I wanted to be sure so I Googled it. According to http://www.thefreedictionary.com, an asylum is

 1. An institution for the care of people, especially those with physical or mental impairments, who require organized supervision or assistance.
2. A place offering protection and safety; a shelter.
3. A place, such as a church, formerly constituting an inviolable refuge for criminals or debtors.
4. The protection afforded by a sanctuary. See Synonyms at shelter.
5. Protection and immunity from extradition granted by a government to a political refugee from another country.

Now that I have that cleared up, here are some pros and cons. An asylum could be useful for an individual with a mental disorder if they have a unstable home life because it may be provoking their illness in some way. Particular circumstances seem like a controlled environment would be more helpful in progressing towards stability.
The biggest con in my opinion is not being able to interact with the world in the same way that a “normal” person can. Sure we have the internet and cell phones now but it’s not the same as being able to physically interact and experience ‘normalness’. Plus, if an individual isn’t interacting with the outside world, he/she may forget how to do so. Once released from the asylum, it could easily be like entering a new culture after having adapted to the asylum way of like and therefore worsen the disorder that the asylum was supposed to be controlling and treating. For some reason To Kill a Mockingbird keeps coming to my mind when thinking about this question. It is clear in this movie some of the effects that long term stays have on patients. The effects are truly mind numbing.

2. Although I have never experienced being diagnosed with such a disorder, I feel that if I were I would begin to believe that I was crazy because stereotypical that’s what a mental disorder implies. The self-fulfilling prophecy concept from social psychology would come into play here if there were characteristics of bipolar disorder that I didn’t exhibit prior to finding out about them but did afterwards. This would make recovery much more difficult. I think it is also difficult when a person know the signs/symptoms and then realizes when they’re exhibiting because it reaffirms that they have the condition which can increase pessimism regarding the disorder and they’re ability to control it. This may cause them to give up on treatments and/or medication if they feel that they’re making no progress.

3. When people feel like they have superpowers, they don’t need medicine. They don’t need therapy. They don’t need advice. They don’t need help. This becomes a major problem for anyone working on the individual’s progression. Carla experienced this when she began throwing her pills away after her release from the hospital and also when she stopped sleeping and starting talking about her future so unrealistically. In order to help a person in this state, one must find a way to convince the individual that they do need medication, therapy or a combination thereof. That task can be a very difficult one. The following links are ones that address how to help someone during a manic episode including some individual cases. I found some of the advice very interesting.

http://www.emedicinehealth.com/bipolar_disorder_helping_someone_during_a_manic_episode-health/article_em.htm http://www.healthcentral.com/bipolar/c/17281/17766/talk-person-manic
http://www.youtube.com/watch?v=PoJY-8bdpEs&feature=related

Also, once an individual is overcoming their manic episode and realizes that they were having one, they may feel like they have lost some of the progress that they made or convince themselves that they don’t want to have to continue going through the same cycles over and over again and commit suicide because of their disorder. That is a worst-case scenario but it can be hard to continuing fighting and having hope when its hard to see a light at the end of the tunnel which is what I believe many individuals with bipolar feel if/when they decide to end their life.

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Learning Assessment #2

My beliefs about abnormal behavior have changed drastically since being in this class. Although I knew there were some folks that truly had mental disorders, I believed a lot of it was basically malarkey and that people were far too often diagnosed with a mental disorder. Now that we have learned about the DSM, I know that there is specific criteria that a client/patient must meet in order to be diagnosed. Prior to this class I was unaware that there was a standardized diagnostic manual for mental health problems. Honestly, I had an extremely naive view of abnormal behavior, its assessment, and its treatment.  I thought mental illness was over-dramatized and portrayed as semi-common in modern pop culture with shows like Monk and movies like A Beautiful Mind and The Soloist seeming commonplace. Although we haven’t discussed all of the disorders depicted in these films, I now realize that they are probably under recognized in popular media today considering that each year 3.1% of the population meets the criteria for generalized anxiety disorder alone. According to the Kim Foundation, “an estimated 26.2 percent of Americans 18 and older… suffer from a diagnosable mental disorder in a given year.” (http://www.thekimfoundation.org/html/about_mental_ill/statistics.html) That is a shocking, almost scary, portion of Americans.

The most shocking thing that I learned about in this unit would definitely have to be agoraphobia. I had never heard of anything like it before this class. It is still hard for me to wrap my head around the biological and psychological stuff that has to be going on in order for an illness to have such control over their lives. Watching the video, I was shocked by the painful effects that were caused by going outside their comfort zone. They were literally terrified. After watching the film, I thought about how hard it would be to live with someone that was agoraphobic. As the wife of the man that could only go about eight to ten miles from his house, I probably would have went crazy myself trying to understand and deal with his disorder. I truly have the utmost respect for those that have to live with it and their families.

Something that I should have done differently in this unit is review all of the Bernheim readings in the nights prior to the exam. I had forgotten some of them which greatly effected my response to one of the short answer questions. Also, I forgot to review the concepts from the first exam which if I had done would have made me feel more confident for the portions of the exam that covered unit one material. Lastly, I should have read the chapters more than I did. This time, I skimmed much more than I read causing me to miss some of the deeper understandings of the material. Hopefully prior to the next exam I will be able to complete all of those tasks as well as the ones that I did for this exam. As the semester progresses and I start to have multiple strenuous exams during a week plus 15-20 hours of labor and other committed volunteer activities, I have to adjust to becoming an expert time manager in order to be successful in all of my activities. I am still working on that.

Also, for the next unit I plan to review the short answer questions that were on this exam because I feel that they were more difficult for me to answer than the first ones and that I did not understand them as well as the ones during the unit one exam.

That’s all for now. Until next time…

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