Patient Portfolio, Essay Example
Part 1: Patient’s Background
|Criteria for the disorder that the patient meets (based on the DSM-5 classification of the disorder)||Depressed mood for most of the day
Markedly diminished interest or pleasure in most daily activities
Ongoing insomnia or hypersomnia
Feelings of worthlessness or excessive guilt
Diminished ability to think or concentrate
Recurrent thoughts of death, suicide ideation, or suicide attempt
Clinically significant distress or impairment
Not associated with bereavement
Persistence for longer than 2 months (Durand et al., 2013)
|Criteria for the disorders that the patient does not meet (based on the DSM-5 classification of the disorder)||Significant weight loss when not dieting or weight gain, or significant decrease or increase in appetite
Psychomotor agitation or retardation
Fatigue or loss of energy
|Patient’s symptoms||Feelings of worthlessness or guilt almost every day, impaired concentration and indecisiveness, insomnia or hypersomnia every day, markedly diminished interest or pleasure in almost all activities every day or nearly every day (anhedonia), restlessness or feeling slowed down, recurring thoughts of death or suicide (WebMD, n.d.).|
|Patient’s main problem (including any emotional problems and abnormal behavior)||Family history of drug abuse, family history of anger problems|
Part 2: Psychological Model/Theory for potential causes
Compare and contrast the psychological approaches of the Psychological Tradition (psychoanalysis, humanism, and behavioral)
Psychologists use psychoanalysis to understand their patient’s behavior on the basis of their unconscious thoughts and processes. Ultimately, this theory of psychological evaluation derived from the belief that people are able to recall information from their unconscious thoughts through hypnotism. Sigmund Freud aimed to take advantage of the unconscious mind in psychoanalysis through the use of conscious thoughts and words as symbols for discovering information that the patient may consciously repress but regularly revisit while they are unconscious. While Freud’s diagnoses weren’t necessarily correct by today’s standards, he certainly helped the evolution of modern psychology and proved the value that having their patients discuss their problems could have on the outcome of their situation.
Humanism evolved in response to Freud’s psychoanalytic theory and states that a holistic approach to the individual being treated in psychology is necessary. The benefit of the humanistic approach compared to psychoanalysis is that it allows us to test psychological theories objectively using the scientific method. While Freud’s method was useful because it helped us form hypothesis about how the human mind works, it didn’t give us means by which to test these theories (Rogers, 1965).
Behaviorism, like psychoanalysis, is difficult to prove using scientific experimentation. However, this school of thought contrasts Freud’s psychoanalysis because it states that we should concern ourselves with the observable behaviors of humans and animals rather than the unobservable (Curtis, 2001). While it is difficult for us to test many of the behaviors we observe experimentally, some talented researchers have been able to do so. Ivan Pavlov’s well-known classical conditioning experiment is an example of this. Therefore, behaviorist theories can be somewhat validated, although not as effectively as the humanistic approach.
Explain which one of the psychological approaches you believe is best applied to understand the patient’s disorder
Since Harrison is experiencing depression, it is essential to intervene using discussion in order to make him realize what is causing him to act and feel this way. As a consequence, psychoanalysis is the best approach in this situation. Since Harrison’s current life appears to be going well with the exception of his present state, the cause for his depression likely lies in his past. Harrison’s mother was a drug abuser and his father was short tempered and may not have treated him as well as he wished. Harrison may believe he has been able to get past this, but it is important for him to revisit his past so he understands that any negativity in the past was not his fault and that his family does not think of him in the same way that he thought about his own parents.
Part 3: Genetic and Environmental Influences
Discuss what studies show about whether genetic or environmental factors contribute the most in the development of the disorder
Twin studies have been an effective way in determining whether genetic or environmental factors contribute the most in the development of this disorder. A 2006 study entitled “A Swedish National Twin Study of Lifetime Major Depression” revealed that lifetime major depression was moderately heritable, although environmental factors did play a role in the disease expression as well (Kendler et al., 2006). This leads researchers to believe that there is a gene or combination of genes that can be inherited that code for depression, although certain environmental factors are required for it to be expressed. It is likely that this is the case with major depressive disorder as well. Many people with depression have family history of the disease, and psychologists also observe that people with depression have experienced some kind of trauma or negative experience in their past. Ultimately, human behavior is influenced by a combination of genetics and environmental factors, although the contributing influence of each factor may vary according to disease or behavior.
Explain and justify whether you support the research suggesting which factor (genetic or environmental) plays a bigger influence in the development of the patient’s disorder
I support the research suggesting that genetic and environmental factors play an approximately equal role in the development of the patient’s disorder. While twins both inherit an identical pair of genes at birth, environmental factors modify these genes and decide which ones remain active or inactive. Many genetic studies have shown that depression runs in families, although not all family members necessarily experience depression even if the gene is present. In twin studies where identical twins are raised by different families, it was found that one twin who experienced negative events during his or her childhood would be more likely to have depression as an adult compared to the other twin. Ultimately, these two types of studies show that both genetics and environmental factors play a major role in contributing to the development of depression.
Part 4: Treatment Plan
Discuss what types of medical approaches (ECT, prescription medications, or psychosurgery) you recommend for the patient based on studies showing its effectiveness in treating the disorder
It is recommended that Harrison regularly visits a psychologist for psychotherapy. In these discussions, it is important that the therapist asks him questions about his childhood, which has been reported by his family to not have been a positive experience. These sessions should continue until Harrison has allowed himself to open up to the therapist about his feelings about how he was treated as a child. If this does not occur after several months of therapy, if Harrison’s situation does not improve after he recognizes the source of his depression, or the root of his depression is multifactorial and outside the scope of the report that was provided, it is possible that he may benefit from prescription medication.
It may also be helpful for a doctor to give Harrison a physical exam to ensure that his depressed situation is purely psychological in nature. As a consequence, a complete blood count (CBC) could be conducted to determine normal thyroid function. If it is found that Harrison has hypothyroidism, he should be prescribed medication for this situation only and be observed to determine whether he improves.
If this is still not effective, Harrison may benefit from a selective serotonin reuptake inhibitor (SSRIs) medication, such as Zoloft. Since there are many other options for depression medications on the market, he should be monitored for both improvement and side effects and be recommended to switch to a different drug if this is found to be the case (Mayo Clinic, n.d.).
Compare and contrast the side effects the patient may experience and what benefits these medications have on the brain chemistry or neurotransmitter activity
Selective serotonin reuptake inhibitors (SSRIs) such as Zoloft work by decreasing the level of serotonin available in the brain for use as a neurotransmitter. It is believed that people who experience depression have higher amount of serotonin available which causes the associated symptoms. There is a wide array of side effects associated with this category of drug, the most prevalent of which is sexual dysfunction. The specific disorders associated with the sexual dysfunction is loss of libido, anorgasmia, and erectile dyfunction. Minor risks of use include cardiovascular problems and discontinuation syndrome. A symptom of potential concern however is increased suicidal thoughts. While this is known to occur in children, there is little evidence for this phenomenon in adults. However, it would be important to monitor Harrison to determine whether his suicidal thoughts are increasing in frequency and recommend a drug change on this basis.
Explain which psychotherapy and techniques you recommend for the patient. Explain how the chosen therapy and techniques will help the patient to manage his or her symptoms (outcome)
Initially, cognitive behavioral psychotherapy would be useful for Harrison because it will allow him to connect his repressed childhood feelings with the emotions and distress that he is currently experiencing. At first, this therapy should be repeated several times a week, although it may eventually be able to be reduced to once a week. At this point, it would be useful to introduce a group therapy session with Harrison’s family involved. It is important for him to understand that he is acting like a completely different person and that it is impacting those around him. His family may be a more helpful tool to Harrison in discovering why he feels the way he does, and the fact that they are there as support may help speed his recovery. Ultimately, it is important for him to know he is not alone. While the psychologist will guide the group sessions, the eventual goal of these sessions will be for the family to talk on their own outside the scope of the psychologists and be able to handle these kinds of issues as a unit, showing strong support for one another.
Provide both short and long-term goals for the patient’s treatment plan. Include accomplishments or behavioral changes you want to see in the patient
The first thing I would like to see is for Harrison to regain an interest in his family. It is essential that this step occurs because his family can help him regain his other interests. Next, I would like him to recognize why he is feeling this way, even though he may be unable to completely recover at this point. I would eventually like to see Harrison being able to regain his sleep patterns and ability to work, and interest in cars.
Part 5: Conclusion
Defend your treatment plan by explaining how the proposed treatment plan would best help the patient compared to another form of treatment
This treatment plan would best help compared to other plans of treatment because it takes into consideration the root of the problem; Harrison has had trouble with his parents in the past, which makes him feel bad about himself. While many healthcare professionals would argue that he should be treated with medication immediately to prevent his suicidal thoughts, depression medication has many side effects and the first medication prescribed may not work. It is essential for Harrison instead to understand that what happened to him is not his fault, and that his family loves him and is there to support him. Once this occurs, it will facilitate future recovery through therapy sessions and discussion with family members.
Brown, Curtis. (2001). Behaviorism: Skinner and Dennett. Philosophy of Mind. San Antonio, TX: Trinity University
Durand, V. M., Barlow, D. H. (2013). Essentials of Abnormal Psychology, 6th Edition. Print.
Kendler KS, Gatz M, Gardner CO, Pedersen NL. (2006). A Swedish National Twin Study of Lifetime Major Depression. American Journal of Psychiatry. Retrieved from http://ajp.psychiatryonline.org/article.aspx?articleID=178000
Mayo Clinic. (n.d.). Depression. Retrieved from http://www.mayoclinic.org/diseases-conditions/depression/basics/treatment/con-20032977
Rogers, C. R. (1965). The place of the person in the new world of the behavioral sciences. In F. T. Severin (Ed.), Humanistic viewpoints in psychology: A book of readings. New York, NY: McGraw-Hill.
WebMD. Depression Health Center. Retrieved from http://www.webmd.com/depression/guide/major-depression
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