By L. Brant. Seattle Pacific University. 2018.
Patients with factitious disorder fake physical symptoms in large part because they enjoy the attention and treatment that they receive in the hospital purchase 500mg xeloda free shipping. Sexual disorders refer to a variety of problems revolving around performing or enjoying sex discount xeloda 500mg with visa. Sexual dysfunctions include problems relating to loss of sexual desire trusted xeloda 500mg, sexual response or orgasm, and pain during sex. Chapter 13 Treating Psychological Disorders Therapy on Four Legs Lucien Masson, a 60-year-old Vietnam veteran from Arizona, put it simply: ―Sascha is the best medicine I‘ve ever had. Lucien has tried many solutions, consulting with doctors, psychiatrists, and psychologists, and using a combination of drugs, group therapy, and anger-management classes. If a stranger gets too close to Lucien in public, Sascha will block the stranger with his body. Sascha is trained to sense when Lucien is about to have a nightmare, waking him before it starts. Before road rage can set in, Sascha gently whimpers, reminding his owner that it doesn‘t pay to get upset about nutty drivers. Sometimes I’ll scratch my hand until it’s raw and won’t realize until she comes up to me and brings me out. The dogs are trained to perform specific behaviors that are helpful to their owners. If the dog‘s owner is depressed, the dog will snuggle up and offer physical comfort; if the owner is having a panic attack, the owner can calm himself by massaging the dog‘s body. Service dogs are constant, loving companions who provide emotional support and companionship to their embattled, often isolated owners (Shim, 2008; Lorber, 2010; Alaimo, 2010; Schwartz,  2008). Despite the reports of success from many users, it is important to keep in mind that the utility of psychiatric service dogs has not yet been tested, and thus would never be offered as a therapy by a trained clinician or paid for by an insurance company. Psychological disorders create a tremendous individual, social, and economic drain on society. Disorders make it difficult for people to engage in productive lives and effectively contribute to their family and to society. Disorders lead to disability and absenteeism in the workplace, as well as physical problems, premature death, and suicide. It has been estimated that the annual financial burden of each case of anxiety disorder is over $3,000 per year, meaning that the annual cost of anxiety disorders alone in the United States runs into the trillions of dollars (Konnopka, Leichsenring, Leibing, & König, 2009; Smit et al. The goal of this chapter is to review the techniques that are used to treat psychological disorder. Just as psychologists consider the causes of disorder in terms of the bio-psycho-social model of illness, treatment is also based on psychological, biological, and social approaches. The social approach to reducing disorder focuses on changing the social environment in which individuals live to reduce the underlying causes of disorder. These approaches include group, couples, and family therapy, as well as community outreach programs. The community approach is likely to be the most effective of the three approaches because it focuses not only on treatment,  but also on prevention of disorders (World Health Organization, 2004). A clinician may focus on any or all of the three approaches to treatment, but in making a decision about which to use, he or she will always rely on his or her knowledge about existing empirical tests of the effectiveness of different treatments. These tests, known as outcome studies, carefully compare people who receive a given treatment with people who do not receive a treatment, or with people who receive a different type of treatment. Taken together, these studies have confirmed that many types of therapies are effective in treating disorder. Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: A systematic review. Costs of nine common mental disorders: Implications for curative and preventive psychiatry. Prevention of mental disorders: Effective interventions and policy options: Summary report. Outline and differentiate the psychodynamic, humanistic, behavioral, and cognitive approaches to psychotherapy. Treatment for psychological disorder begins when the individual who is experiencing distress visits a counselor or therapist, perhaps in a church, a community center, a hospital, or a private practice. The therapist will begin by systematically learning about the patient‘s needs through a formalpsychological assessment, which is an evaluation of the patient’s psychological and mental health. In some cases of psychological disorder—and particularly for sexual problems—medical treatment is the preferred course of action. For instance, men who are experiencing erectile dysfunction disorder may need surgery to increase blood flow or local injections of muscle relaxants. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level: Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities Often has trouble keeping attention on tasks or play activities Often does not seem to listen when spoken to directly Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions) Often has trouble organizing activities Often avoids, dislikes, or doesn‘t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework) Often loses things needed for tasks and activities (e. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level: Often fidgets with hands or feet or squirms in seat Attributed to Charles Stangor Saylor. One approach to treatment is psychotherapy, the professional treatment for psychological disorder through techniques designed to encourage communication of conflicts and insight.
Sex is intrinsically an interaction between individuals order 500 mg xeloda mastercard, yet many areas of psychology traditionally study individuals on their own discount xeloda 500 mg with mastercard. Furthermore purchase xeloda 500mg with amex, the recent emphasis on sex as a risk to health and resulting attempts to examine indi- viduals’ competence at protecting themselves from danger, may have resulted in a more individualistic model of behaviour. This problem of interaction is exacerbated by the psychological methodologies available (unless the researcher simply observes two people having sex! They also raise the question of how much can and should psychologists be concerned with the context of individual behaviour? Sex as a risk and pregnancy avoidance A focus on sex for pleasure and an emphasis on sex as a risk has resulted in a literature on contraception use and pregnancy avoidance. Psychologists have developed models in order to describe and predict this behaviour. Researchers have used several diﬀerent classiﬁcations of contraception in an attempt to predict contraceptive use. In addition, diﬀerent measures of actual behaviour have been used when predicting contraception use: s at ﬁrst ever intercourse; s at most recent intercourse; s at last serious intercourse; s at last casual intercourse. This produced a wealth of data about factors such as age of ﬁrst intercourse, homosexuality, attitudes to sexual behaviours and contraception use. These results suggest that the younger someone is when they ﬁrst have sex (either male or female), the less likely they are to use contraception. The results from this survey also show what kinds of contraception people use at ﬁrst intercourse. The diﬀerent measures of contraception use have implications for interpreting ﬁndings on contraception. Developmental models are more descriptive, whereas decision-making models examine the predictors and precursors to this behaviour. Developmental models Developmental models emphasize contraception use as involving a series of stages. Therefore, they describe the transition through the diﬀerent stages but do not attempt to analyse the cognitions that may promote this transition. Lindemann’s three-stage theory Lindemann (1977) developed the three-stage theory of contraception use, which suggests that the likelihood of an individual using contraception increases as they progress through the three stages: 1 Natural stage: at this stage intercourse is relatively unplanned, and the individual does not regard themselves as sexual. It suggests that contraception use is more likely to occur at a stage when the individual believes that sexual activity is ‘right for them’. This process involves the following four stages: 1 Falling in love: this provides a rationale for sex. Decision-making models Decision-making models examine the psychological factors that predict and are the precursors to contraception use. There are several diﬀerent decision-making models and they vary in their emphasis on individual cognitions (e. Rosenstock 1966; Becker and Rosenstock 1987) and is described in detail in Chapter 2. They added the following variables: s self-esteem; s interpersonal skills; s knowledge about sex and contraception; s attitudes to sex and contraception; s previous sexual, contraceptive and pregnancy experiences; s peer norms; s relationship status; and s substance use prior to sex. Therefore, although this model still examines cognitions, it includes measures of the individuals’ cognitions about their social world. The theory of reasoned action This theory was developed by Fishbein and Ajzen (1975) and is described in detail in Chapter 2. It therefore represents an attempt to add the social context to individual cognitive variables and consequently addresses the problem of interaction. In addition, research by Werner and Middlestadt (1979) reported correlations between attitudes to contraception and subjective norms and actual use of oral contraception. Sexual arousal refers to how aroused an individual is at the time of making a decision about contraception. Herold and McNamee’s (1982) model This model is made up of the following variables: (1) parental and peer group norms for acceptance of premarital intercourse; (2) number of lifetime sexual partners; (3) guilt about intercourse and attitudes to contraception; (4) involvement with current partner; (5) partner’s inﬂuence to use contraception; and (6) frequency of intercourse. This model diﬀers from other models of contraception use as it includes details of the relation- ship. It places contraception use both within the general context of social norms and also within the context of the relationship. In summary These decision-making models regard contraceptive use as resulting from an analysis of the relevant variables. However, they vary in the extent to which they attempt to place the individual’s cognitive state within a broader context, both of the relationship and the social world. Integrating developmental and decision-making approaches to contraception use Developmental models emphasize behaviour and describe reliable contraception use as the end product of a transition through a series of stages. These models do not examine the psychological factors, which may speed up or delay this transition. In contrast, decision-making models emphasize an individual’s cognitions and, to a varying degree, place these cognitions within the context of the relationship and social norms.
Right ventricle 3 Follow a drop of blood from the anterior tibial vein to the lungs cheap xeloda 500 mg visa. Lung capillaries Chapter 11 Keeping Up Your Defenses: The Lymphatic System In This Chapter Delving into lymphatic ducts Noodling around with nodes Exploring the lymphatic organs ou see it every rainy day — water generic xeloda 500mg otc, water everywhere discount xeloda 500mg without a prescription, rushing along gutters and down Ystorm drains into a complex underground system that most would rather not give a second thought. Well, it’s time to give hidden drainage systems a second thought: Your body has one. Interstitial or extracellular fluid moves in and around the body’s tissues and cells constantly. It leaks out of blood capillaries at the rate of nearly 51 pints a day, carrying various substances to and away from the smallest nooks and crannies. But the one or two liters of extra fluid that remain around the tissues become a substance called lymph that needs to be managed to maintain fluid balance in the internal environment. That’s where the lymphatic system steps in, forming an alternative route for the return of tissue fluid to the bloodstream. It’s a body-wide filter that traps and destroys invading microorganisms as part of the body’s immune response network. It can remove impurities from the body, help absorb and digest excess fats, and maintain a stable blood volume despite varying environmental stresses. We bet that you won’t take your little lymph nodes for granted anymore after you’re done with this chapter. Duct, Duct, Lymph The story of the lymphatic system (shown in Figure 11-1) begins deep within the body’s tis- sues at the farthest reaches of blood capillaries, where nutrients, plasma, and plasma pro- teins move out into cells, while waste products like carbon dioxide and the fluid carrying those molecules move back in through a process known as diffusion. Roughly 10 percent of the fluid that leaves the capillaries remains deep within the tissues as part of the interstitial (meaning “between the tissues”) fluid. But in order for the body to maintain sufficient volume of water within in the circulatory system, eventually this plasma and its protein must get back into the blood. So the lymphatic vessels act as a recycling system to gather, trans- port, cleanse, and return this fluid to the bloodstream. To collect the fluid, minute vessels called lymph capillaries are woven throughout the body, with a few caveats and exceptions. There are no lymph capillaries in the central nervous system, teeth, outermost layer of the skin, certain types of cartilage, any other avascular tissue, and bones. And because bone marrow makes lymphocytes, which we explain in the next section, it’s considered part of the lymphatic system. Plus, lacteals (lymphatic capillaries found in the villi of the intes- tines) absorb fats to mix with lymph, forming a milky fluid called chyle. Made up of loosely overlapping endothelial cells anchored by fine filaments, lymph capillaries behave as if their walls are made of cellular one-way valves. When the pressure outside the capillary is Chapter 11: Keeping Up Your Defenses: The Lymphatic System 183 greater than it is inside, the filaments anchoring the cells allow them to open, permit- ting interstitial fluid to seep in. Rising differential pressure across the capillary walls eventually forces the cell junctions to close. Once in the capillaries, the trapped fluid is known as lymph, and it moves into larger, vein-like lymphatic vessels. The lymph moves slowly and without any kind of central pump through a combination of peristalsis, the action of semilunar valves, and the squeezing influence of surrounding skeletal mus- cles, much like occurs in veins. In the skin, lymph vessels form networks around veins, but in the trunk of the body and around internal organs, they form networks around arteries. Lymph vessels have thin- ner walls than veins, are wider, have more valves, and — most important — regularly bulge with bean-shaped sacs called lymph nodes (more on those in the later section “Poking at the Nodes”). Just as small tree branches merge into larger ones and then into the trunk, lymphatics eventually merge into the nine largest lymphatic vessels called lymphatic trunks. The biggest of these at nearly 1 ⁄12 feet in length is the thoracic duct; nearly all the body’s lymph vessels empty into it. Only those vessels in the right half of the head, neck, and thorax empty into its smaller mate, the right lymphatic duct. Lymph returns to the bloodstream when both ducts connect with the subclavian (under the collarbone) veins. The thoracic duct, which also sometimes is called the left lymphatic duct, arises from a triangular sac called the chyle cistern (or cisterna chyli) into which one intestinal trunk and two lumbar lymphatic trunks (which drain the lower limbs) flow. Both the thoracic duct and the much smaller right lymphatic duct drain into the subclavian (behind the collarbone) veins. The remaining four trunks are a pair serving the jugular region (sides of the throat) and a pair serving the bronchomediastinal region (the cen- tral part of the chest). To see how much of this information is seeping in, answer the following questions: 1. Produce lymphocytes Poking at the Nodes Lymph nodes (see Figure 11-2) are the site of filtration of the lymphatic system. Also sometimes incorrectly referred to as lymph glands — they don’t secrete anything, so technically they’re not glands — these kidney-shaped sacs are surrounded by connective tissue (and therefore are tough to spot). Lymph nodes contain macrophages, which destroy bacteria, cancer cells, and other matter in the lymph fluid. Lymphocytes, which produce an immune response to microorganisms, also are found in lymph nodes.
Te synthesis by Lunt and Law51 continues to be the most comprehensive data available (also see Kraus and Jordan52) xeloda 500 mg visa. Consequently 500mg xeloda overnight delivery, most primary teeth possess a neonatal line if the infant survives birth generic xeloda 500 mg otc. Mandibular m1 typically has the crown apices mineralized and united, with the occlusal table com- plete and evidence of enamel-dentine deposition along the crown’s neck. Root growth progresses throughout the frst year of life, completing for the incisors at about 1½ years of age, but not until about 3¼ years for the canines. Problems with the use of formation stages are (1) there are few distin- guishable grades and (2) there are “gaps” between one stage and the next. And yet, it is evident that crown-root mineralization is a continuous, seam- less process. Liversidge and coworkers provide predictive equations for the deciduous (and some permanent) teeth. Teir data show that, between birth and about fve years of age, tooth length increases on the order of 0. Tey studied the eighteenth- and nineteenth-century internments of known age from Christ Church, London. Te method shows promise of pro- viding fner age estimation57 than when using ordinally spaced morphologi- cal grades. Liversidge and Molleson58 showed that the method can be applied to radiographs of the teeth, so extracted elements are unnecessary. An important convention when using these schemes is that the exam- iner should score the highest grade that has been attained (Moorrees, per- sonal communication), because this improves repeatability. If a tooth’s morphology places it between two grades, one should pick the higher grade actually achieved, not the “closer” grade, nor should one try to interpolate between grades. Mineralized cusps are united so Root length is at least as great as B the mature coronal morphology F crown length. Te crown is about half formed; the pulp chamber is evident and Root walls are parallel, but C G dentinal deposition is occurring. Crown formation is complete to the Apical ends of the roots are D dentinoenamel junction. H completely closed, and the Te pulp chamber has a periodontal membrane has a trapezoidal form. With appropriate consideration, though, one can use actual teeth from recently deceased or archaeological material. Records of young children (less than about ten years of age) were examined from the Boston area. Tis is a simplifcation of the sixteen-grade scheme developed by Gleiser and Hunt50 and of the nineteen-grade scheme constructed by Fanning. In practice, these graphs proved time-consuming and inefective (but they are commonly reproduced in the literature). Harris and Buck “reverse engineered” these graphs to provide the data in a more usable format (Tables 13. Te data age estimation from oral and dental structures 275 were derived from the cross-sectional study of children attending a dental school in Tennessee for routine dental care (Tables 13. An exception would seem to be dysmorphic teeth, including microform and pegged teeth, where the formative status is ques- tionable. In Westernized settings, where the subject may have been exposed to chemotherapy or irradiation during growth, one needs to be alert to abnor- mal crown-root forms. Te simplest suggestion for combining the individual tooth age estimates is to average across all scorable teeth. Te third molar is notorious in this regard, with unusually high variability, and it is omitted from some scoring systems. Just the mandibular teeth are used because of their greater clarity on radio- graphs (whereas several maxillary teeth are obscured by the complex bony architecture), and because there is considerable statistical redundancy among the teeth in the two arches. Likewise, teeth from just the lef (or from the clearer, better preserved) side are used because of the duplication of informa- tion between sides. Tere are four steps in the Demirjian system: (1) the extent of crown-root development of the seven teeth is scored (Figure 13. Several researchers have computerized this sequence of events to minimize the arithmetic. Stages: initiation (i), coalescence (co), cusp outline complete (co), complete (c), clef (cl). Te solution is to produce group-appropriate norms that accurately refect the target group’s tempo of growth. Demirjian refected that the statistical information among the seven tooth types was largely redundant since the teeth were developing synchronously. Afer this, the variable third molar is the only tooth that has not yet completed root formation. Focus then turns to age estimation based upon the aging and, ofentimes, degenerative processes associated with adulthood, or to techniques that look at histological, bio- chemical, or special changes in teeth.
Early in 2008, Sue Clark brought a handful of epigenetics researchers from Australia together to form the Australian Epigenetics Alliance. The AEpiA has now grown to a membership of nearly 300, with members spanning not only Australasia, but the globe. Last year we hosted our seventh flagship conference, Epigenetics 2017 in Brisbane, QLD, and the WA team are already busy preparing for Epigenetics 2019 – watch this space!
Past Epigenetics meetings: