Research Articles Base: Psychology

Minnesota Multiphasic Personality Inventory (MMPI) – Adolescent

Minnesota Multiphasic Personality Inventory (MMPI) – Adolescent     Final Paper       (Name) (University)       DATE         Abstract             This paper discusses the details importantly to take note of regarding the Minnesota Multiphasic Personality Inventory-Adolescent or MMPI-A. This describes the historical background of the test in order to provide useful background or support of the discussion. It also includes the general description of the test, which would be highly useful in the progression of the discussion. Psychometric qualities of the test were also provided, which includes the standardization, validity, and reliability of the test. Its varied uses were also given importance, such as its use in the clinical or medical, legal or forensic, and psychological uses. A critique of the test was done through determining and analyzing the strengths and weaknesses of the test, by stating its psychometric qualities, and by discussing the relevant ethical and legal issues involved in its use. Part of the paper is to specify its use in the practical setting, which indicates its purposes, benefits, challenges, and use of the results of the test. At the end of the paper, a conclusion was done, which places emphasis on the summary of what was discussed in the paper and the personal thoughts of the author.               Table of Contents   Title Page                                                                                                                    1 Abstract                                                                                                                      2 Table of Contents                                                                                                       3 Introduction                                                                                                                4 Description of the Test and Its History                                                                      4 Psychometric Qualities of the Test                                                                             6 Uses of the Test                                                                                                          8 Critique of the Test                                                                                                     10 Description of the Use of the Test in Own Setting                                                    13 Conclusion                                                                                                                  14 References                                                                                                                  16       Introduction             The drastic changes happening in the society today significantly affect the welfare, personality, perceptions, and even the future of adolescents, thus, affecting the future of the entire society as well. Such changes lead to more serious problems that result to emotional, physical, and psychological damages in individuals that consequently yield to other social problems, such as increased rates and cases of juvenile delinquency, crimes involving adolescents, abortion, single-parenthood, and diseases caused by sexual aggression, such as AIDS and sexually-transmitted illnesses. With these problems at hand, the field of psychology would be able to help the society, particularly the adolescents in terms of introducing psychological tests, which would assist adolescents in measuring their personality, such as the MMPI-A or the Minnesota Multiphasic Personality Inventory-Adolescent. The different details about the test, including its qualities and uses are discussed in the paper, including its critique and application. At the end of the paper, a conclusion is provided in order to highlight the important points discussed in the paper.   Description of the Test and Its History (Important Evolutionary Milestone)             It has been reported by Archer (2005) that the work on the Minnesota Multiphasic Personality Inventory or the MMPI was begun by Stark R. Hathaway, a psychologist, and J.C. McKinley, a neuropsychologist, in 1937. The authors of the test were motivated to come up a “personality inventory” based primarily on noticing that a large proportion of clients for medical treatment manifested psychoneurotic complaints. As such, Hathaway and McKinley sought to develop an instrument that would be useful in determining and describing clients in a manner that was more effective and appropriate than using psychiatric interview techniques, which are traditionally used for psychological evaluations of medical clients. During the continuous development and administration of the test, its application is extended to adolescent populations for both clinical and research purposes. Although the administration of MMPI was intended for individuals who were 16 years of age and older, Dahlstrom et al (1972) noted that it can be also used effectively with “bright children as young as 12”, thus, the delineation of age 12 as its lower limit in terms of MMPI administration was probably related to the estimate that a sixth-grade reading level was a prerequisite for understanding the MMPI item pool (p. 24).             The year 1941 marks the first research application of the MMPI with adolescents, which is two years before the formal application of MMPI in 1943. Dora Capwell, in 1945 indicated that the test has an ability to accurately discriminate between groups of delinquent and non-delinquent adolescent girls based on Pd scale elevation. The validity of the test was also proven by Hathaway and Monachesi, who collected the largest MMPI data set ever obtained on adolescents, in a longitudinal study of the relationship between MMPI findings and delinquent behaviors. In the end, the study done by Hathaway and Monachesi proved to be very valuable in a number of ways, namely, by (1) establishing that the MMPI can usefully predict at least one broad area of important behavior exhibited by adolescents, which is delinquency; (2) providing a body of crucial information concerning differences in item endorsement for male vs. female adolescents and for adolescents vs. adults; (3) providing a major component of the traditionally used adolescent norms, which is later developed by Marks and Briggs; and (4) providing an extraordinarily rich source of data for follow-up investigations of the original Hathaway and Monachesi subjects, across topics from the prediction of juvenile delinquency to the personality precursors of schizophrenia (Archer, 2005, pp. 30-32). Thus, with such findings, at present, the Minnesota Multiphasic Personality Inventory is now the most frequently used objective personality instrument employed with adolescents (Janus et al., 1998, p. 321). It is now the most frequently used self-report measure to determine adolescents who are in need of psychological intervention and used to identify such adolescents from those displaying the normal spectrum of emotional and behavioral liability (as cited in Hand et al., 2007, p. 80). With this, it is often employed in court cases in order to provide personality information on defendants or litigants in which psychological adjustment factors are relevant to the resolution of the case. Its administration is fairly easy, thus, providing an objective measure of personality. Being a well-researched and highly-reliable instrument, the test is often used in custody evaluations, as it provides clear and valid descriptions of the problems, symptoms, and characteristics of individuals in broadly accepted clinical language. In addition, the profiles are manageable to explain in court and appear to be relatively simple for people to comprehend (Karp and Karp, 2008).     Psychometric Qualities of the Test (Standardization, Reliability and Validity)             Standardization of the Test. It has been indicated that the MMPI was re-standardized in 1992 specifically for use with adolescents, in part to resolve normative confusion and to modify its original form for more appropriate use with adolescent respondents. The development of the MMPI-A involved the collection of normative data for 805 boys and 815 girls between the ages of 14 and 18, inclusive. Its final form included the original 13 basic validity and clinical scales with significant basic scale changes largely restricted to scales F, Mf, and Si. Although endorsement frequencies for the MMPI-A items were examined, comparisons between normative and clinical samples were not used as criteria in retaining or modifying the basic scales. It also included the development of 15 content scales, where eleven overlap with similar measures developed for MMPI-2, whereas 4 scales were uniquely developed for the MMPI-A (Archer et al., 2001, p. 421).               Reliability. Groth-Marnat (2003) reports that reliability studies indicate that MMPI-A had moderate levels of temporal stability and internal consistency, due to fluctuations in some scales. For example, Scale 2 (Depression) is particularly likely to be lowered after successful treatment; Scale 7 (Psychasthenia) would be likely to change according to an individual’s external situation. Thus, in this sense, test-retest reliability may actually be an inappropriate method of evaluating these scales for certain populations. In addition, this defense of the tests’ reliability is somewhat undermined by the observation that test-retest reliability is actually slightly more stable for psychiatric populations than for normals. Whereas the media range for psychiatric clients is about .80, media reliabilities for normals are about .70. Split-half reliabilities are likewise moderate, having an extremely wide range from .05 to .96 with median correlations in the .70s (as cited in Groth-Marnat, 2003, p. 221).             Validity. It has been indicated that findings from studies of the MMPI-2 and MMPI-A have mostly been consistent with studies done of the original MMPI. Investigations and studies have suggested that an incremental, though modest, contribution to the accuracy of clinical prediction when the MMPI is compared or combined with other sources of clinical information. Moreover, evidence for the convergent validity of the MMPI, MMPI-2, and MMPI-A is generally recognized to be better than that for its discriminant validity. The method of contrasted groups, in which the item responses of a pathological criterion group are contrasted with those of a diverse group of psychiatrically healthy individuals, used for the development of the basic clinical scales has been the subject of criticism on both theoretical and psychometric grounds. Thus, in this regard, this method of scale construction increased sensitivity but allowed considerable item overlap, giving rise to enhanced correlations among the clinical scales and reduction of specificity and compromising discriminant validity. As a result, the test tends to perform better in discriminating between major psychiatric conditions than it does within them (American Psychiatric Assocation, 2000, p.91).   Uses of the Test             Primarily, the basic use of MMPI-A is in clinical settings. One clinical application of its use has been emphasized in the study done to address concerns about the mixing of different developmental ages, use of inadequate comparison groups, and the lack of reliance on reliable and valid measures of psychological, behavioral, and psychosocial problems used in previous studies of sexually abused children and adolescents. Through the administration of the test, the study has found out that a number of significant differences between reportedly sexually abused and non-sexually abused on the MMPI-A scales are reported, and a significantly larger proportion of sexually abused participants were diagnosed with post-traumatic stress disorder had numerous difficulties. Based on the tests, sexually abused adolescents had significantly higher elevations on scales that reflect thoughts of self-harm, depression, feelings of worthlessness, withdrawal from others and frequent running away. In addition, adolescents with such elevations tend to see their future as hopeless, feel that no one understands them, and consequently, respond minimally to treatment (Forbey et al., 2000, pp.9-10). Thus, clinicians must be able to take note of such factors in order to provide better diagnosis and treatment for such adolescents.             Another use of the MMPI-A is for research purposes. It has been emphasized that the test manual for MMPI-A not only provides extensive data based on its normative sample but also provides psychometric data derived from a clinical sample of 420 boys and 293 girls between the ages of 14 and 18, inclusive. It also provided the mean MMPI-A profiles for 1,032 girls and 730 boys in psychiatric treatment who had completed the original MMPI, with the protocols rescored on MMPI-A norms. Through the test, a variety of studies have already been studied in relation to profile characteristics of adolescents in residential or inpatient psychiatric facilities, eating disorder programs, and in several inpatient and outpatient treatment programs for juvenile offenders (Forbey et al., 2000, p.3). Thus, in this regard, it can be understood that the test significantly provides additional information and knowledge regarding the different issue at hand.             The next use of MMPI in adolescents is having knowledge regarding their personality and measuring their type of personality, which would be very helpful in assessing and understanding themselves. Once an adolescent or his/her parents or guardians are able to have adequate knowledge regarding their personality, then they would able to come up with strategies that would contribute to behavior modification, most especially when the behavior of the adolescent creates nuisance or havoc to the family, community or society. In relation to this are the forensic or legal uses of the MMPI-A. There are a variety of referral questions that the MMPI-A can be useful for answering, as the clinical constructs assessed by this instrument are often relevant to forensic issues or to individuals being treated in forensic settings. Some of the uses include competency to stand trial and insanity evaluations, personal injury and disability assessments, and assessment of general mental functioning for purposes of placement and treatment planning (Archer, 2006, p.70).   Critique of the Test (Strengths and Weaknesses, Psychometric Qualities and Issues)             Strengths and Weaknesses. Primarily, its strength is its ability to provide a comprehensive clinical description for adolescents (Reynolds and Kamphaus, 2003, p.384). The test is helpful in assessing and evaluating the personality and associated behaviors of the adolescents, thus, making it easier to understand them. It also evaluates a wide range of symptoms and areas of functioning (Reynolds and Kamphaus, 2003, p.384), which can be used in clinical, psychological, and legal settings. In addition, clinicians using MMPI-A recognize the value of the updated normative sample, which is nationally representative, and includes minority populations (Reynolds and Kamphaus, 2003, p.384). In this sense, the sample does not exclude other representatives of the population, making the test more reliable and valid. The use of the test indicated ease of administration and psychometric soundness. This is because many of the newer scales, particularly the content scales have excellent internal consistency. Another major strength of the test is its ability to check for response biases and its ability to evaluate profile validity. This is because the test includes validity scales, which were also strengths of the MMPI, such as F, L, and K. In addition to such validity scales are the VRIN and TRIN scales, which show promise for determining inconsistent responding or a tendency for acquiescent or non-acquiescent responding. Lastly, the MMPI-A’s research base is supported by decades of MMPI investigations (Reynolds and Kamphaus, 2003, p.384), thus, making the descriptors and correlates of the test highly supported by studies and facts derived from researches.             However, despite such strengths are a number of weaknesses of the MMPI-A, which include its foundation. This is because most of the basic clinical scales were retained with minimal modification, thus, several of such scales show low internal consistency, specifically when evaluated by today’s standards. In addition, many items are found on more than one scale, thus, contributing to higher correlations among scales. This can lead to uncertainty and confusion in the process of interpretation. Another weakness is that a significant number of items on both the basic and content scales do not demonstrate differential rates of endorsement between clinical and normative groups (Reynolds and Kamphaus, 2003, p.384).             Psychometric Qualities. The Minnesota Multiphasic Personality Inventory had a long history of use in the assessment of adolescents in various settings, including inpatient and outpatient psychiatric programs, substance abuse programs, and juvenile justice facilities. Similar to the parent and sister instruments of the MMPI-A, the individual scales of the MMPI-A often show appreciable intercorrelation. Factor analyses of the basic clinical and validity scales suggest that four factors account for the majority of the observed variance in scales scores. Furthermore, the large number of individual scales and subscales available on the MMPI-A serves to make the interpretation process quite complex for many clinicians, particularly given the varying degree of overlap between the scales (Archer et al., 2002, pp.1-2).             Specific Ethical and Legal Issues. It has been indicated that psychologists using the MMPI-A must adhere to ethical guidelines governing both psychological assessment and professional practice with minors. The “Ethical Principles of Psychologists and Code of Conduct” notes that users of psychological assessment devices must have appropriate training and expertise. The manual of the MMPI-A indicates that competent use of the MMPI-A requires knowledge of psychopathology and diagnosis, adolescent development and personality, and psychometric principles and concepts, as well as mastery of the MMPI-A’s content and structure. Although technicians may administer and score the MMPI-A, they must be thoroughly trained and closely supervised by qualified psychologists. The ethics code of the American Psychological Association also requires discussion with adolescents and their parents or guardians of the limits of confidentiality, the purpose of the assessment, how assessment results will be used, and the extent to which feedback will be provided and to whom. These issues become especially complex in forensic settings, where assessment may be ordered by the court (Hersen, 2004, p.219). In relation to its use in forensics, ethical and legal issue involves evaluating adolescents in civil cases rests on its ability to provide an overview of the plaintiff’s psychological or emotional functioning in reference to well-established adolescent norms (Archer, 2006, p.70).   Description of the Use of the Test in Own Setting             Purpose. In the hospital setting, the purpose of the MMPI-A is to provide appropriate diagnosis and treatment to clients, particularly to the adolescents concerned with by the test. It also allows understanding of the issues and problems experienced or faced by the adolescents in the family, community, and society. Another objective or purpose of the use of MMPI-A is to provide relevant solutions for the problems of the adolescents, thus, helping them avoid or prevent severity of their psychological, emotional, and social problems.             Benefits/Usefulness. One of the benefits of using the MMPI-A is to obtain more knowledge about the practice, thus, enabling medical practitioners to have develop more skills in the area. Another benefit is exposure to different cases, thus, having more references for future applications. The use of the test also provides more accurate and more relevant procedures for better diagnosis and treatment. Lastly, better medical practice can be developed through using the test.             Challenges. The lack of cooperation and communication among the staff and the clients is one challenge. The lack of knowledge in the administration and the use of the results of the test are also considered. The lack of priority in using the test and the lack of recognition of its importance and implications are also challenges.             How Results would be Used. Results would be used for additional researches. They can also be used for better treatment of the adolescents. The results can be used to provide better analysis of the problems of the adolescents in the community, thus, giving them useful and relevant options as solutions.   Conclusion             Based on the discussion, it can be deduced that the use of MMPI-A is relevant and significant in the field of psychology, particularly in relation to clinical, legal, and psychological applications. The different details regarding the test were provided, including the major descriptions, validity, reliability, standardization, strengths and weaknesses, and its practical applications in the medical field. In addition, the historical background was specified in the beginning of the discussion in order to provide a background of the test. The different uses of the test were also identified, thus, emphasizing its practicality and applicability in different fields.             In terms of its future applications, I believe that due to the rich sources and researches to support it, more and more applications can be thought of and proven in relation to the use of MMPI-A. In addition, the many uses and benefits of using the test serve to be the basis for its continued use in the clinical, legal, and psychological field. In the future, it can be perceived that more fields would be using the MMPI-A, such as education, sociology, politics, and economy. Furthermore, future applications of the test may also involve its further modification, which would help its users in terms of better application and results. Thus, it can be suggested that in addressing its limitations or weaknesses, the use of the test would be far more relevant and applicable in the present situation of the community and society, particularly in helping the society address the problems that concern the welfare of the adolescents.       References American Psychiatric Association. (2000). Task Force for the Handbook of Psychiatric Measures. Handbook of Psychiatric Measures, 1st ed. USA: American Psychiatric Association. Archer, R.P. (2006). Forensic Uses of Clinical Assessment Instruments. New Jersey: Lawrence Erlbaum Associates, Inc. Archer, R.P. (2005). MMPI-A: Assessing Adolescent Psychopathology, 3rd ed. Mahwah, New Jersey: Lawrence Erlbaum Associates, Inc. Archer, R.P., Bolinskey, P.K, Morton, T.L. and Farris, K.L. (2002). A Factor Structure for the MMPI-A: Replication with Male Delinquents. Assessment, 9(4): 319-326. Archer, R.P., Handel, R.W. and Lynch, K.D. (2001). The Effectiveness of MMPI-A Items in Discriminating Between Normative and Clinical Samples. Journal of Personality Assessment, 77(3): 420-435. Forbey, J.D., Ben-Porath, Y.S. and Davis, D.L. (2000). A Comparison of Sexually Abused and Non-Sexually Abused Adolescents in a Clinical Treatment Facility using the MMPI-A. Child Abuse & Neglect, 24(4), 557-568. Groth-Marnat, G. (2003). Handbook of Psychological Assessment, 4th ed. New Jersey: John Wiley & Sons, Inc. Hand, C.G., Archer, R.P., Handel, R.W. and Forbey, J.D. (2007). The Classification Accuracy of the Minnesota Multiphasic Personality Inventory-Adolescent: Effects of Modifying the Normative Sample. Assessment, 14(1): 80-85 Hersen, M. (2004). Comprehensive Handbook of Psychological Assessment. New Jersey: John Wiley & Sons, Inc. Janus, M.D., de Groot, C. and Toepfer, S.M. (1998). The MMPI-A and 13-Year-Old Inpatients: How Young is Too Young?. Assessment, 5(4): 321-332. Karp, C.L. and Karp, L. (2008). General Information on the MMPI. Retrieved May 15, 2008, from http://www.deltabravo.net/custody/mmpi-info.php. Reynolds, C.R. and Kamphaus, R.W. (2003). Handbook of Psychological and Educational Assessment of Children: Personality, Behavior, and Context, 2nd ed. New York: The Guilford Press.                     Credit:ivythesis.typepad.com

Minnesota Multiphasic Personality Inventory (MMPI) – Adolescent

Minnesota Multiphasic Personality Inventory (MMPI) – Adolescent Final Paper (Name) (University) DATE ...

Depict The Different Issues and Concerns Youth Encounter from Decision Making and Judgment

Part I Naturalistic Decision Making (NDM)             Naturalistic decision making is defined by Zsambok (1997) as the way in which people use their experience in making their decisions in the field settings (p. 4). Naturalistic decision-making emerged as a separate research paradigm in the late 1980s and enjoyed considerable popularity in the 1990s. NDM was born out of a reaction to the limited ability of experimental methodologies to study complex, real life tasks. Tasks typically studied by NDM researchers are dynamic, continuous, potentially stressful and are usually carried out by cooperating teams (Bowling and Ebrahim 2005). NDM focuses on how decisions are made in complex, real-world environments. The implications of NDM are: <ul style="margin-top: 0in; margin-bottom: 0in" type="circle"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> NDM has focused attention on how decision makers bring their experience to bear in making a decision.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> NDM broadens the focus of the decision-making research from the decision event to the larger processes of situation assessment.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> NDM emphasizes that different cognitive strategies and processes are used when the decision situation is viewed as a temporarily evolving one rather than a fixed event; that action and perception are crucial aspects of cognition; that human resource limitations are important factor in decision making; and that human decision making competence should be emphasized (Klein and Woods 1993). </li> </ul>     Styles and Methods of Decision Making             Aron Katsenelinboigen was the one who presented an elaborate account of styles and methods of decision making with his Predisposition Theory. Katsenelinboigen made reference to the game of chess in his analysis of the styles and methods of decision making asserting that chess reveals different methods of operation, particularly the creation of predisposition, a method that is applicable to other more complex systems. According to Katsenelinboigen (1997), there are two major styles in chess that can be applied in complex more decision-making – combinational and positional.             The combinational style according to Katsenelinboigen (1997) features a clearly formulated limited objective, namely the capture of material (the main constituent element of a chess position). The objective is implemented via a well defined and in some cases in a unique sequence of moves aimed at reaching the set goal. As a rule, this sequence leaves no options for the opponent. Finding a combinational objective allows the player to focus all his energies on efficient execution, that is, the player’s analysis may be limited to the pieces directly partaking in the combination. This approach is the core of the combination and the combinational style of play (p. 57). In the combinational style, the player is not concerned with the creation of a predisposition for his future development since he is completely seized with the goal, which is a material objective. In the process, everything not linked to the capturing of the material objective is not considered by this type of player, and the question of what kind of predisposition will be created after the goal has been achieved is not of his concern (Ulea 2002).             Unlike the combinational player, the positional player is occupied, first and foremost, with the elaboration of the position that will allow him to develop in the unknown future. In playing the positional style, the player must evaluate relational and material parameters as independent variables.   Strategies of Problem Solving 1. Rational Emotive Behavioral Therapy (REBT)             Rational emotive behavioral therapy was introduced by Albert Ellis (1996). It was a modification of his earlier theory known as Rational Therapy. REBT’s philosophical underpinnings deal with questions such as ‘how we know what we know’ (epistemology), the role of logical thought and human reason in the acquisition of knowledge (dialects), goals for which individuals strive (values), and the criteria and standards for deciding how to relate to others (ethics) (Bernard and Joyce 1984, p. 39). Epistemology             REBT rests on the assumption that our knowledge is based on our selective interpretations of our world. How a person perceives events and people will largely impact how that person thinks, feels and behaves. The philosophy underlying REBT assumes that no absolute truth or reality exists but that each person’s truth or reality is internally defined and experienced. Dialects             The role of logic in the acquisition of knowledge is central to REBT. Rationality and logic dictate that individuals consider all pertinent evidence before drawing a conclusion. At the very least, a rational thinker would understand that no conclusion can be based on all information, so the conclusion/ belief may need to be modified or changed as new evidence is discovered. Values             Proponents of REBT believes that enjoying life is s primary goal and rational individual strive to maximize pleasure. Pure hedonism would involve achieving pleasure at any cost, but REBT adherents, who emphasize personal responsibility, advocate responsible hedonism. A person who is responsibly hedonistic is able to create short- and long-term goals that maximize pleasure potential. A pure hedonist would sacrifice long-term goals for short-term pleasure, while a responsible hedonist would forgo short-term pleasure if it meant achieving long-term pleasure goals. Ethics             REBT embraces the humanistic philosophy of appreciating the individuality, creativity, and autonomy of the person. REBT proponents believe in the innate worth of every individual and believe that dysfunction arises out of a need to criticize self and make comparisons between self and others. Ellis views these comparisons and self-evaluations as thoroughly destructive and irrational. No universal criteria exist regarding right and wrong, pretty and ugly, or good and bad. Therefore, all such criteria are arbitrary, and to criticize oneself for not living up to some arbitrary standard sets one up for unnecessary distress (Fall et al 2003). 2. Cognitive Behavioral Therapy (CBT)             The major thrust of CBT is toward the understanding and identification of patient’s behavioral patterns and precipitating and accompanying cognitive process. Cognitive process include current and automatic thoughts, self-statements, perceptions, appraisals, attributions, memories, goals, assumptions, standards, and beliefs. Principles of CBT             One of the major principles of CBT is that one’s basic assumptions play a central role in influencing perception and interpretation of events and in shaping both behavior and emotional responses. These basic assumptions or rules that govern individual thought and behavior develop over years and are called schema. Schema guide every aspect of the individual’s life. They provide meaning and structure to a world that is flooding our senses with information, and they are created through years of development. They provide the blueprint or the template for beliefs through which receptive information is processed and filtered. This method of organization is in accord with an existing system complete with rules and meanings. From these basic beliefs, automatic thoughts are generated, Automatic thoughts are the immediate conscious stream of thoughts that are generated from schema. Automatic thoughts can be rational though still dysfunctional, biased, or distorted. CBT aims to help patients change dysfunctional thoughts and, by testing and challenging these thoughts, change the underlying schema (McGinn and Sanderson 2001).   Youth Decision Making: Biases             Teaching rational decision making must not only be focused on adults. Adolescents also commit serious and irrational decisions that have consequences on their long term goals. There is an increasing number of phenomena that occur to this age that are results of irrational decision making. These phenomena include teenage pregnancy, AIDS, behavior disorders and substance abuse. It is important that problems in decision-making such as biases are dealt with in the adolescence period. Poor decision making may be mediated by  a number of heuristics and biases. Biases can be divided into those that involve search and those that involve inference. Biases of Search <ul style="margin-top: 0in; margin-bottom: 0in" type="circle"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Insufficient Search – insufficient search leads to impulsiveness. Adolescents and adults differ in their willingness to sacrifice accuracy for speed in problems that require thinking. </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Single-Mindedness – people tend to make holistic decisions in terms of a single dominant dimension. </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Myside Bias – a decision maker may neglect his or her desires in the future and the desires of other people both now and on the future. This can be caused by over attention to the satisfaction of immediate desires. </li> </ul>   Biases of Inference <ul style="margin-top: 0in; margin-bottom: 0in" type="circle"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Sunk-cost Effect – characterize by sticking with plans even though the decision-maker believes that the future will be better if he or she is to give up them. </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Endowment Effect/ Framing Effects – people overvalue what they have as opposed to what they might obtain.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Omission Bias </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Neglect of Uncertain Outcomes or Imperceptible Outcomes (Baron and Brown 1991). </li> </ul>             Part II High-Risk Behaviors of the Decision Making Adolescent             The behaviors associated with the major mortalities and morbidities of adolescents share common theme: risk taking. Young people with limited or no experience according to Irwin (1990), engage in potentially destructive behaviors with anticipation of benefit and without understanding the immediate or long-term consequences of their actions. According to Baumrind (1987) even though some risk taking is necessary in the normal development process, often the short- and long-term results of risk taking are disastrous. High-risk behaviors that lead to mortality and morbidity among adolescents include the following: <ul style="margin-top: 0in; margin-bottom: 0in" type="circle"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Motor and Recreational Vehicle Use – in the United States unintentional injuries and accidents among adolescents caused by motor and recreational vehicle use are among the leading causes of premature mortality.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Sexual Behavior – Evidence shows that there is a dramatic increase in sexual activity among adolescents. </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Substance Use and Abuse – Substance use and abuse remains as one of the top problems involving adolescents (Susman et al 1992). </li> </ul>   Adolescent’s Social Cognitions             Cognitive development of Adolescents as it plays out in its social context and its effects on the development of judgment, decision making and risk taking is becoming a new direction in research. Adolescent thinking is a function of social and emotional, as well as cognitive processes. Studies indicate that patterns of social cognitive development in adolescence, like patterns of cognitive development, vary both as a function of the context under consideration and the emotional and social context in which the reasoning occurs. For example, even if the individuals’ thinking about moral dilemmas becomes more principles over the course of adolescence, their reasoning about real-life problem is not as advanced as their reasoning about hypothetical dilemmas (Steinberg 2005).   Social Influence on Decision Making: Family, Peer, the Media             Theory indicates that social influence occurs when people continually compare themselves with others to ascertain whether or not their own behavior is appropriate (Turner 1991). As the child moves toward adolescence, it strives to create a self image apart from its parents. To aid with this identity formation, peer groups, outgroups, and role models provide the child with significant social comparisons, supplying opportunities and experiences (Maxwell 2002). Part of the task of adolescence is to gradually move away from the family and out into the world. Thus, peers commonly assume a larger influence over time. In a dysfunctional family, the influence of peers on decision-making may be unusually strong (Gordon 1996). Adolescents are influenced by their peers. Because of peer influence and social pressure, many adolescents engage in risk-taking behaviors. These adolescents run a high risk of committing various antisocial and delinquent acts, including substance abuse (White et al 1990). Lack of parental supervision and the lack of alternative recreational activities further increase the risk of substance abuse (Hawkins et al 1992). Gang membership and participation is also seen as a risk for substance abuse. Society as a whole serves to promote reliance on alcohol, tobacco, and other drugs as an access to an exciting life. In addition, the media is also seen as a contributing factor to the growing problem in substance abuse. Advertisements tend to glamorize and sensationalize drinking, smoking and drug use in the eyes of young viewers.   Risky Decisions of Drug Use and Sex             Irwin and Millstein (1986) attempted to explain adolescent risk taking using a model that combined both biological and psychosocial factors. According to their biopsychosocial model, the timing of biological maturation (puberty) affects the four following aspects of an individual adolescent: his or her scope (egocentrism, future orientation); his or her self-perceptions (self-esteem, body image); his or her perception of the social ennvironment (perception of parental and peer influence); and his or her personal values (desire for independence or achievement). These four factors, in turn, affect their risk perceptions (costs and benefits of options, optimistic bias and controllability) and peer group characteristics (peer age, peer values, and peer behavior). Finally, adolescents’ risk perceptions and peer group characteristics, in turn, affect their tendencies to engage in risk-taking behavior.             The strong desire to develop intimate relationships with other adolescents sometimes overrides all other factors; even though pregnancy may not be desired, the adolescent may risk it for the sake of intimacy (Rogel et al 1980).   Part III Programs for Improving Decision Making Skills 1. GOFER                  GOFER stands for Goals clarification, Option generation, Fact-finding, consideration of Effects, and Review and implementation.  The Gofer course is based on Janis and Mann’s (1977) conflict theory of decision-making under stress. The course entails 40 to 50 hours of lessons that are taught over an academic year. The target audience is 15-year-olds. The course content is presented in a teacher’s manual, two textbooks, and student workbooks. One of the textbooks focuses on the basic principles of decision making and the other focuses on decision making in practice. The book on basic principles describes the nature of decision making, the GOFER strategy as a technique for making good decisions, and the problems that arise when a GOFER step is missed. In addition, students are told about the relation between self-esteem and decision making, as well as techniques for performing each of the GOFER steps in an optimal way. For example, they are told how to define problems, clarify goals, and check the reliability of information. The second textbook on decision making in practice illustrates the approach in several areas that have significance for adolescents (Byrnes 1998). 2. Personal Decision Making             Personal decision making (Ross 1981) conceives of the decisionmaking process as involving five steps: (a) identifying a set of alternative courses of action, (b) identifying appropriate criteria, (c) evaluating alternatives by these criteria, (d) summarizing information about alternatives, and (e) self-evaluation. The program is based on an explicit descriptive theory of how untrained individuals approximate the skills used by sophisticated decision makers, identifying five developmental stages for each of these five steps. The instructional package contained 10 lessons, each requiring about one hour of class time. Detailed, virtually scripted lesson plans were constructed containing directions for teachers and students. The first lesson consisted of a pretest and a teacher-directed analysis of a typical problem designed to identify the five steps of decision making. Two lessons were devoted to each of the first three steps and one lesson was given to each of the remaining steps. The ninth and tenth lessons consisted of a review of the five steps and posttest (Ross 1981).       REFERENCES   Baron, J. and Brown, R. V. (Eds.). (1991). Teaching Decision Making to Adolescents. Hillsdale, NJ: Lawrence Erlbaum Associates.   Bernard, M.E. and Joyce, M.R. (1984). Rational emotive therapy with children and adolescents. New York: Wiley.   Bowling, A. and Shah, E. (Eds.). (2005). Handbook of Health Research Methods: Investigation, Measurement and Analysis. Maidenhead, England: Open University Press.   Byrnes, J. P. (1998). The Nature and Development of Decision Making: A Self-Regulation Model. Mahwah, NJ: Lawrence Erlbaum Associates.   Hawkins, J. D., Catalano, R. F. and Miller, J. Y. (1992). Risk and Protective           Factors for Alcohol and Other Drug Problems: Implications for Substance           Abuse Prevention. Psychological Bulletin.   llis, A. (1996). Better, deeper, and more enduring brief therapy: The rational emotive behavior therapy approach. New York: Brunner/Mazel.   Klein, G. A. and Woods, D. D. (1993). Conclusions: Decision making in action. In G. A. Klein, J. Orasanu, R. Calderwood, and C. E. Zsambok (Eds.), Decision making in action: Models and methods (pp. 404-411). Norwood, NJ: Ablex.   Katsenelinboigen, A. (1997). The Concept of Indeterminism and Its Applications: Economics, Social Systems, Ethics, Artificial Intelligence, and Aesthetics. Westport, Connecticut: Praeger.   Maxwell, K. A. (2002). The Role of Peer Influence across Adolescent Risk Behaviors. Journal of Youth and Adolescence, 31(4), 267.   McGinn, L. and Sanderson, W. (2001). What Allows Cognition Behavioral Therapy to be Brief: Overview, Efficacy, and Crucial Factors Facilitating Brief Treatment. Clinical Psychology: Science and Practice, 8(1), 23-37.   Rogel, M. J., Zuehlke, M. E., Petersen, A. C., Tobin-Richards, M. and Shelton, M. (1980). Contraceptive behavior in adolescence: A decision-making perspective. Journal of Youth and Adolescence, 9, 491-506.   Ross J. A. (1981). Improving adolescent decision-making skills. Curriculum Inquiry, 11, 279295.   Susman, E. J., Feagans, L. V. and Ray, W. J. (Eds.). (1992). Emotion, Cognition Health, and Development in Children and Adolescents. Hillsdale, NJ: Lawrence Erlbaum Associates.   Turner, J. C. (1991). Social Influence. Brooks/Cole, Pacific Grove, California.   Ulea, V. (2002). A Concept of Dramatic Genre and the Comedy of a New Type: Chess, Literature, and Film. Carbondale, IL: Southern Illinois University Press.   White, H. R., Bates, M. E., and Johnson, V. (1990). Social Reinforcement and           Alcohol Consumption. In W. M. Cox (Ed.), Why People Drink (pp. 233-262). New York: Gardner Press.   Zsambok, C. E. (1997). Naturalistic decision making: Where are we now? In C. E. Zsambok & G. Klein (Eds.), Naturalistic decision making (pp. 3–16). Mahwah, NJ: Lawrence Erlbaum Associates.         Credit:ivythesis.typepad.com

Depict The Different Issues and Concerns Youth Encounter from Decision Making and Judgment

Part I Naturalistic Decision Making (NDM) Naturalistic decision making is defined by Zsambok (1997) as the way in which peop...

Freud claims our dreams are structured according to four grammatical rules, what are they, and how does he apply them to the wolf man’s famous dream?

Freud claims our dreams are structured according to four grammatical rules, what are they, and how does he apply them to the wolf man’s famous dream?   “Dreams play an important and often underestimated role in cultural transmission because they provide personal experiential verification of incoming information” – (Kilborne 1981, pp. 165-185) Four Grammatical Rules of Dream Structures <li class="MsoNormal" style="line-height: 200%"> Freud – primitive languages as intended for communication but dream was not a vehicle for communication (Freud, 1990 p. 341) </li> <li class="MsoNormal" style="line-height: 200%"> Would be interpreter of dreams has no rules for semantic substitution as dream interpretation resembles the decoding methods of ancient dream books which fixed meaning set out, necessary for the individual to provide associations to the elements of his dream (Freud, 1901 p. 684) </li> <li class="MsoNormal" style="line-height: 200%"> There are no syntactic rules, production of manifest elements by dream work is not governed by anything having character of grammatical rules of language but lack definite enabling ambiguous expressions to be deciphered (Dreams are divided into parts for the principal and the other for the dependent clause) </li> <li class="MsoNormal" style="line-height: 200%"> Freud, the interpretation of dreams was by no means completely analogous to the decipherment of ancient pictographic script such as Egyptian hieroglyphics (Freud, 1913 p. 177) </li>     Amicably, Freud applies the dream structures in lieu to wolf man’s dream as one narrative assumption of language in grammar essence upon the studying of the dream as one narrative shifts attention from interpretation to analysis interpretation makes the meaning of dream clear to the dreamer, who is trying to grasp its references to both external and internal worlds, analysis identifies the tale’s form, as well as the characters, theme and structure. A dream cannot be interpreted without grammar associations that provide references, but it still can be analyzed as text and its narrative structure studied. Thus, certain study analyzed the frequency of grammar forms and words used in dream telling. Since the research does not require synthesis based on content categories, it allows generalizations that are independent of any theoretically based interpretative model. The process relates to Freud’s case of the wolf man as the latter remain one of favorite teaching case, certainly most detailed, documented of Freud’s case histories upon recording original discoveries and solution of complicated enigmas of symptom and character, personality development and regression. The layers of dream meaning presented vividly, with clarity and cohesion pioneering formulation fostering insights and appreciation of new grammatical cues within the language denoted in dreams. Freud states that if sense of reality accompanies dream, analysis have showed that one or more latent thoughts in it do in fact refer to something real such as by sense of reality, in which two pears that the dreamer is given represent the maternal breasts, which the dreamer had once indeed received. The quality of realness in the dream indicates the reality present in the original situation. Freud’s use of covert methods of interpersonal control, such as the fixed time limit on the length of his analysis, the Wolf Man gave in and provided material Freud could use to support his theories and reconstructions, such as the primal scene interpretation of the nightmare about wolves. Freud fostered misalliance with Wolf Man and prevented the formation of a therapeutic alliance. Thus, along structural interaction with Wolf Man, Freud enacted transference complex organized and activated by the Wolf Man’s need for an idealized omnipotent and powerful person, the need to maintain relationship with Freud and to gratify needs, Wolf Man unconsciously complied with the pressures imposed on him by Freud’s use of indoctrination methods and such grammar formation, for example proponent, Foulkes (1999) has tackled Freud’s dream structures from within guiding behavior, topographical, structural and genetic based models, attempt to build on shortcomings of Freud’s attempted grammar rooted and or topographical model for explaining dream formation and content. Furthermore, dreams have been the subject of extensive investigation through psychoanalysis since its inception.  The ideal composition of allegory through wolf man’s dream is being applied to grammar effectiveness and usage particular to English literatures and other forms. The detail and clarity of Freud’s reconstruction of such cases provides not only model of psychoanalytic investigation, but also an important testing ground against which the development of psychoanalytic insights and understanding can be paired off with the formulations of the founder of psychoanalysis, the greater appreciation for the congruence and continuity of analytic insights, or it may be conversely sharpening and focusing of the differentiation of such insights as factor of scientific progress. The case of the Wolf Man stands in the first rank of Freud’s clinical studies and has been object of continuing analytic interest since its original publication in 1918 (Freud, 1918; Gardiner, 1971) such as the Wolf Man’s seduction by his sister at the age of four can claim to be taken as memories in the ordinary sense of the word. Others are interpretive elaborations, worked up from the barest of memory fragments. The most important memory reported by the patient is a dream. Freud characterised dreams as ‘another kind of remembering, although one that is subject to the conditions that rule at night and to the laws of dream-formation’(Freud 1918, p. 285), if my surmise about them is correct, then the task of discovering just what it is that dreams remember comes down to search for the implicit metaphorical structures underlying the transformation of the day’s residues by the dreamwork the structures are the infantile scenes. According to Freud, the transferential process guiding the dreamwork was fundamentally the same as that seen in neuroses and in the analytic situation (Freud Interpretation, pp. 601-2).   Though subject to conditions that rule at night there reflected the same infantile scenes and mediated the same conflicts. Thus there are good grounds for regarding the relationship between infantile scenes and the behaviour of neurotics as a metaphorical one as well. Freud thought of this pattern as originating in one or more infantile scenes, but acknowledged that these could be known only indirectly, through the traces they left on various aspects of the patient’s symbolic productions. We can now add that, from the standpoint of Freud’s interpretive practice with patients, it did not matter whether these scenes had any basis in historical reality, since their relation to the raw materials of analysis was never historical or causal, but metaphorical. In constructing them Freud was guided by his theoretical assumptions, but needed to instil that sense of conviction which he saw as therapeutic equivalent of actual recollection. Viewed strictly as an interpretive practice, psychoanalysis will be shuttling between two poles: the first consists of patient’s symbolic productions his dreams, recollections. The second pole is situated in the space of early childhood memory and consists of small cluster of ambiguous but emotionally potent figures, drawn from the master trope of infantile sexual life: the breast and so on. The work of grammar implied interpretation is process of reading figures into life and symbolic productions and fleshing the figures until arrangement will be found capturing truth of current predicament.   References   Foulkes, D. (1999) see. PsycINFO Database Record, 2009 APA Freud, Sigmund, From the History of an Infantile Neurosis (‘The Wolf Man’),’ in A. Richards (ed.) Sigmund Freud: Case Histories II, London, Penguin, 1979 [1918].   Freud, Sigmund, ‘Totem and Taboo,’ in A. Richards (ed.) Freud: The Origins of Religion, London, Penguin Books, 1984 [1913].   Kilborne, B (1981) Pattern, Structure, and Style in Anthropological Studies of Dreams  Ethos, Vol. 9, No. 2 (Summer, 1981), pp. 165-185  Blackwell Publishing Freud, S. (1918). From the history of an infantile neurosis. In M. Gardiner (Ed.) 1971.   Endnotes   Sigmund Freud, ‘From the History of an Infantile Neurosis (‘The Wolf Man’),’ in A. Richards (ed.) Sigmund Freud: Case Histories II, London, Penguin, 1979 [1918], p. 285.   Freud repeatedly underscored the connection between the two kinds of transference in the Interpretation of Dreams, he wrote: We learn from [the psychology of neurotics] that an unconscious idea as such is quite incapable of entering the preconscious and that it can only exercise any effect there by establishing a connection with an idea which already belongs to the preconscious, by transferring its intensity on to it and getting itself covered by it. Here we have the fact of transference, which provides an explanation of so many striking phenomena in the mental life of neurotic. The unconscious prefers to weave its connections around preconscious ideas which are either indifferent or have been rejected – (Freud, Interpretation, pp. 601-2).  Gardiner, Muriel (Ed.) (1971). The Wolf-Man. With The case of the Wolf-Man, by Sigmund Freud and a supplement by Ruth Mack Brunswick. Foreword by Anna Freud. New York, Basic Books. Sigmund Freud, “The ‘Uncanny’” (1919) in The Penguin Freud Library Volume 14: Art and Literature, trans. and ed. James Strachey (London: Penguin, 1990): 341     Credit:ivythesis.typepad.com

Freud claims our dreams are structured according to four grammatical rules, what are they, and how does he apply them to the wolf man’s famous dream?

Freud claims our dreams are structured according to four grammatical rules, what are they, and how does he apply them to the wolf man’s f...

The Keirsey Temperament Sorter

The Keirsey Temperament Sorter Introduction There are two sides of personality, the temperament and the other is the character. The temperament is a set of preference that are natural on everyone since the birth of an individual, while character is a set of habits that an individual acquire as he/she gains maturity. People naturally think and talk about the things they are interested at. The traits, like the communications, actions, and attitudes can create different impressions for other people. Theory The Keirseian temperament theory by describing prominent learning styles lead to the four temperament types. The preferred strategies of the analysis can emphasize cooperation and personal applications of learning. The improvement that the participants received through the instructions and suggestions can utilize teaching strategies which matched their temperament-based learning styles (Horton, 1997). The Study The study of temperament determines the traits, level of intelligence, or how people think, act, and feel. The traits determine the special talents, emotional needs and a kind of life that is bound to be fulfilled and satisfied. The same traits also determine both of the learning and teaching styles, and can enhance or hinder the development of a person (Golay, 2002). The mentors are based on learning styles as determined in the Keirsey Temperament Sorter in four categories named as artisan, guardian, idealist, and rational (Williams, 2003). The guardians are the cornerstone of the society, for they are given to serving and preserving our most important social institutions. The idealists are the passionately concerned with personal growth and development. Their quest to self-knowledge drives their imagination. The rational types are the problem-solving temperament. They are rigorously logical and value competence and ingenuity above all. The artisan want to be where the action is and they are spontaneous, adaptable and competitive, they believe today must be enjoyed. Design The design of the temperament was used to measure personality and attitudes toward the practice of mental discipline which are calculated from the ratings given by the participants (Smith, 2003). The Keirsey Temperament Sorter is a most widely used instrument that is available in Website. There are 70 powerful questions of personality instrument that helps individuals to discover their personality type, how to develop, and use it well. Most people rely in this kind of temperament not only to utilize their skills but gradually understand the others. The program offered a combination of training, consulting or coaching through their professional services. The purpose of the self-analysis material is to measure and identify the skills and personality attributes of ones person (Santiago, 1999). The temperament study explores the possibility of making self-based attributions, since that knowledge might influence the validity of the study (Howell, 2004).  In terms of science and medicine, the temperament sorter can determine the personality, more specifically over a patient that can affect the fast rehabilitation of the patient, no matter how complicated the situation is. Reflection             According to the temperament sorter, I am an artisan type that had a natural ability to excel in any kind of arts, whether in fine arts, performing arts, athletics, or the “art deal” in business. Artisans also seek adventure and viewed the present day need to be enjoyed in case tomorrow might not come. There results are based on the questions that I answered and most of the reports they presented reflects on who am I. They also presented that was designed for planning the future careers, preferences in career development, enhancing communication, and providing specific steps for an accurate learning. The validity of the results still depends on the person who took the same test and assessed in his own point of view.             In the relation towards the holistic rehabilitation, there’s a suggestion in improving the communication, understanding the preferred working environment as well as, understanding the behaviors of others. And if I am a nurse and mastered the field of the medicine, the temperament sorter can possibly help me understand the things that my patients are dealing with. I can deliberately explain to them the essence of their medication, the anticipated pain, and future outcomes in a way that the patients can easily digest. The rehabilitation of the patient depends on how the patient contributed in his own health and the purpose of a nurse is to guide the patient towards his recovery. Conclusions The Temperament Sorter helps an individual understand his own temperament and gain insights from other individual. Understanding the role and functions can help an individual capitalize the personal strengths to build the success. The natural ways of gaining new ideas, wisdom, and self-knowledge which includes the identification of the particular temperament impacts and influence others is a better step in lasting ties or connections with others.  References: Golay, K., (2002).Introducing the Animal Kingdom – It’s a Jungle out There!. American Music Teacher Magazine. Music Teachers National Association. Vol. 52, No. 2. Williams, D., (2003). Software: A Ninth House Roundup. T & D Magazine. American Society for  Training and Development. Vol. 57, No. 8. Smith, M., (2003). The Physiology of the “Psi-Conductive” Experimenter: Personality, Attitudes towards Psi, and Personal Psi Experience. The Journal of Parapsychology. Parapsychology Press. Vol. 67, No. 1. Santiago, P., (1999). Self-Analysis for Career Development. The Journal of Business Communication Quarterly. Association for Business Communication. Vol. 62, No. 3. Howell, S., (2004). Students’ Perceptions of Jesus’ Personality as Assessed by Jungian – Type Inventories. Journal of Psychology and Theology. Rosemead School of Psychology. Vol. 32, No. 1. Horton, C. B., & Oakland, T., (1997). Temperament-Based Learning Styles Moderators of Academic Achievement. Journal of Adolescence. Libra Publisher. Vol. 32, No. 125. Credit:ivythesis.typepad.com

The Keirsey Temperament Sorter

The Keirsey Temperament Sorter Introduction There are two sides of personality, the temperament and the other is the character. The te...

WRITTEN DIAGNOSTIC AND TESTING EXERCISE

WRITTEN DIAGNOSTIC AND TESTING EXERCISE   There has been underlying interests imposing incidence of personality disorders as found within individuals and for this particular report, certain diagnosis of DSM-IV is comprehensive upon assessing through case situations focusing on Rita and Alice as subjects. The prospect of DSM assessments is rather been situated into disciplinary silos of personality formation at demarcation of mental illness. The clinical usage of the DSM IV-TR will clarify the incidence and clinical assessment of Rita and Alice and when the patterns are identified as recurring destructive behaviors, they result in significant distress in social and personal areas of functioning that impacts the individual, as Rita and Alice situation does require diverse diagnosis like, structured case history as well as interviews from within assessment of the medical and psychology meeting criteria for effective diagnosis exercise and in process of conveying cases, there serves better action for interdisciplinary collaboration in studying personality disorders (in, American Psychiatric Association, 2000).   CASE ONE   RITA A.   Rita is a 15 year old high school student.  Recently her parents have been awakened by her crying out in the night.  This has happened about twice a week for a month.  When they rush in to try to comfort her she seems unresponsive.  She sits in the bed perspiring profusely, breathing rapidly, her pulse racing.  After a few moments she relaxes and is more alert.  She isn’t able to remember what so terrified her.  Rita’s parents contacted a physician to try to ascertain what was causing this problem.               Rita is doing well in school and has a lot of friends who visit her house often.  Her parents are warmly supportive of their children, and the family functions very well.  The only thing Rita or her parents could think of that was outside the norm, as far as past behaviour or function, was that Rita had lost a good deal of weight during the past year.  She had gone on a diet to lose 2-5 kilos but had actually reduced her weight from 58 to 48 kilos.  Still, she is concerned that her waistline is too thick.  Rita has not had her menstrual period in the last 8 months and her doctor diagnosed amenorrhea.     OUTLINES FOR DIAGNOSTIC SUMMARIES     CASE:  Rita A   Axis I: Clinical disorders Anxiety as well as stress disorder as reflected through a possible peer pressure Amenorrhea as caused by having a diet that may lead to stress   Axis II: Personality disorder Rita’s personality conforms to unresponsive actions, rapid breathing and pulse rising and often shows alertness and seems to forget which terrified her.  Rita’s parents contacted a physician to try to ascertain what was causing this problem.   Axis III: General medical conditions Rita had amenorrhea due to stress and anxiety which resulted to lost her menstrual period for 8 months and Rita had lost good deal of weight   Axis IV: Psychosocial and environmental problems   CHECK:                                                                                SPECIFY:    Problems with primary support group:  Rita was unresponsive to her parents   Problems related to the social environment: shows problem within the classroom    Educational problems: Rita is doing well in school but can be affected by having lose of weight and amenorrhea   Occupational problems:   Housing problems:   Economic problems:   Problems with health care access:   Interactive problems with legal system/crime:   Other psychosocial and environmental problems: the occurrence of possible peer pressure issues/problems   Axis V: Global assessment of functioning scale   Score: ……..3.2…….                          Time frame:  2-3 WEEKS     Justification and discussion (attach sheets) DIAGNOSTIC OUTLINE FOR SAMPLE CASE: DID   Diagnostic criteria for DID Examples from case     A.  The presence of two or more distinct identities or personality states (each with its own relatively enduring patterns of perceiving, relating to, and thinking about the environment and self).       B.  At least two of these identities or personality states recurrently take control of the person’s behaviour.         C.  Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.         D.  The disturbance is not due to the direct physiological effects of a substance (e.g.. blackouts or chaotic behaviour during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.         There can be presence of anxiety related to stress and a possible indication of anorexia nervosa can be evident as she loses weight of about 10 lbs due to diet     Amenorrhea adhering severe stress as reflected more on the mind set and thinking towards others.     Rita has the ability to ignore real situations along her as she tries to forget what are specific instances that have terrified her to act differently in the past months     Anxiety disturbance is not merely on the primary support groups but can be within Rita’s social environment, school setting she belongs.     Anorexia Nervosa  that are in profound dietary problems as she can have eagerness to change her self due to peer pressure Amenorrhea as a most common domain for having severe anxiety and stress for a particular event that have happened in Rita’s life         MENTAL STATUS INTERVIEW OUTLINE   1.         Preliminary identification     Name: Rita A Age: 15 A high school student Rita lives together with her supportive parents The appearance was aloof to receive care and attention Lacks tangible expression and emotion and shows certain degree of alertness at times   2.         Development of rapport   Private session with the physician, one on one interaction and interim counseling 3.         Chief complaint   Data concerning the following should be gathered:   <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="line-height: 150%"> Behaviour:  unresponsive, relaxed and alert behavior </li> <li class="MsoNormal" style="line-height: 150%"> Affect:            self conscious and timid may be seen </li> <li class="MsoNormal" style="line-height: 150%"> Somatic:  no menstrual flow for 8 months time </li> <li class="MsoNormal" style="line-height: 150%"> Interpersonal:  good parental and familial relationship, as well as with peers at school </li> <li class="MsoNormal" style="line-height: 150%"> Perception:  there is feelings of depersonalization or derealization </li> <li class="MsoNormal" style="line-height: 150%"> Thought processes: self  distraction as caused by losing weight and diet </li> <li class="MsoNormal" style="line-height: 150%"> Cognition:  fare mind set and knowledge skill </li> <li class="MsoNormal" style="line-height: 150%"> Judgment:  misunderstanding of accepted values as a teenager, too tight on judging intermittent situations, problems within social groups </li> </ul>         4.         History of present disorder Crying at night showing changes into Rita’s physical attributes, Reduction of the body weight was evident as Rita is on diet    5.         Medical and family history   Not indicated but can somehow caused by family problems if there is any   6.         What will happen next   Since, Rita is having Amenorrhea it is advisable for her and her family to seek more medical support and help probably the best option is to seek an OB-Gyne to evaluate on the situation and suggest useful options to resolve the problem and maybe Rita can enroll into teen counseling session as there can be found within the community if asked     CASE TWO   ALICE C.   Alice, at age 50, showed unfounded jealousy toward her husband as the first noticeable symptom of disease.  Soon thereafter she began displaying an increasing loss of memory and, at times, could not find her way around her own house. She would carry objects around and hide them, or she would think someone was trying to kill her and begin screaming loudly.  After five years of increasing degeneration her husband decided that she should be evaluated and placed her in a hospital.               In the hospital Alice appeared utterly perplexed. She was totally disoriented to time and place.  At times she didn’t recognize her doctor and assumed he was just a visitor.  At other times she accused him of wanting to cut into her or of wanting to have sex with her.  Periodically she became totally delirious, dragging her bedding around, screaming for her husband and daughter, and appearing to have auditory hallucinations.               When examined by a neurological consultant Alice seemed confused and uncomprehending.  She could not remember any one of six objects after an interval of ten minutes, even when prompted.  Her speech was well articulated, but vague and circuitous.  She could not complete even the simplest mathematical calculation and had difficulty in finding similarities between related objects.  She could not remember the names of common objects or what year it was.               A neurological examination showed normal cranial and peripheral nerve function. All laboratory studies were normal.  However, a computerized tomography (CT) scan showed marked cortical atrophy.  Shortly after her consultation she began to lost weight, took to bed, and developed contractures.  Six months later she died of pneumonia.    OUTLINES FOR DIAGNOSTIC SUMMARIES   CASE:  Alice C.   Axis I: Clinical disorders Dementia as caused by loss of memory     Axis II: Personality disorders Alice displays loss of memory as well as increased degeneration Alice was totally delirious, dragging her bedding around, screaming for her husband and daughter and appearing to have auditory hallucinations   Axis III: General medical conditions   A neurological examination showed normal cranial and peripheral nerve function. However, a computerized tomography (CT) scan showed marked cortical atrophy.  Died due to pneumonia   Axis IV: Psychosocial and environmental problems   CHECK:                                                                                SPECIFY:   Problems with primary support group:  In the hospital Alice appeared utterly perplexed. She was totally disoriented to time and place.  At times she didn’t recognize her doctor and assumed he was just a visitor.      Problems related to the social environment:   Educational problems:   Occupational problems:   Housing problems: Soon thereafter she began displaying an increasing loss of memory and, at times, could not find her way around her own house. She would carry objects around and hide them, or she would think someone was trying to kill her and begin screaming loudly.    Economic problems:   Problems with health care access:   Interactive problems with legal system/crime:   Other psychosocial and environmental problems: At other times she accused him of wanting to cut into her or of wanting to have sex with her.  Periodically she became totally delirious, dragging her bedding around, screaming for her husband and daughter, and appearing to have auditory hallucinations.   Axis V: Global assessment of functioning scale   Score: …….4.40……..                                    Time frame:  2 MONTHS     Justification and discussion (attach sheets) APPENDIX C           DIAGNOSTIC OUTLINE FOR SAMPLE CASE: DID   Diagnostic criteria for DID Examples from case     A.  The presence of two or more distinct identities or personality states (each with its own relatively enduring patterns of perceiving, relating to, and thinking about the environment and self).       B.  At least two of these identities or personality states recurrently take control of the person’s behaviour.         C.  Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.         D.  The disturbance is not due to the direct physiological effects of a substance (e.g.. blackouts or chaotic behaviour during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.     No recognition of the doctor, the feeling of being a visitor, thinking that environment is too violent for her as she screams and hallucinates   Auditory hallucinations and delirious actions take control of Alice          Inability to remember series of things and events, loss of memory and right cognition is present, does not have the ability to recall names and important information   The severe disturbance is not been in composed of a substantial events into Alice life but can be directly to increase degeneration and the lack of self trust and attachment to herself     MENTAL STATUS INTERVIEW OUTLINE   1.         Preliminary identification   Name: Alice C Age: 50 Living with husband and daughter Alice appearance was pale and shivers from moment to moment    2.         Development of rapport   Provide comfort and acceptance to Alice within proper application of communication        3.         Chief complaint   Data concerning the following should be gathered:   Behaviour:  unfounded jealousy toward her husband, screams, didn’t recognize her doctor and accused the doctor of wanting to have sex with her totally delirious and appearing to have auditory hallucinations. She could not remember any one of six objects after an interval of ten minutes, even when prompted.  Her speech was well articulated, but vague and circuitous.  She could not complete even the simplest mathematical calculation and had difficulty in finding similarities between related objects.  She could not remember the names of common objects or what year it was.   Affect: showing of possible dementia disease   Somatic:  neurological examination and computerized tomography (CT) scan Interpersonal:  belongs to a ideal family with husband and daughter Perception:  delusions, hallucinations Thought processes:  incompatible speech Cognition:  severe loss of memory Judgment:  unrealistic judgment     4.         History of present disorder   Unfounded jealousy towards her husband as the first symptom of the disease, long term disorders leading to Alice death due to pneumonia, proper assessment given with the aid of a physician     5.         Medical and family history No prior medical intervention aside, CT scan and neurological exam and Alice husband decided to enter her in hospital for immediate care   6.         What will happen next   Provide enough care assistance as well as support for Alice family, to her husband and daughter for her death as grieving needs attention           _________________ American Psychiatric Association (2000), DSM IV-TR: Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, Arlington, VA Retrieved information from: http://allpsych.com/disorders/dsm.html             ______________________________________     ANSWERS TO THE CASE QUESTIONS   Ruth’s Case   a)            What could you conclude about Ruth’s ability from the K-BIT test?   I can conclude that Ruth’s ability as based on the K-BIT test imposes a very good intelligence marking from within the test sub-sets as the test results shows a 95 percent rank from a score of 124 in vocabulary and matrices set  and a composite score of 127 from within a 90 percent confidence interval thus, it shows that Ruth is very good in such vocabulary domain and also comprehends well to solving problems and has good reasoning skills.   b)           What are the limitations of the estimate of her ability?   The limitations with regards to the estimate of Ruth’s ability can be that there can be possibility that she may lack verbal as well as non-verbal abilities that may pertain to speech and communication in both oral and written presentation but, only a small percentage of lapses can incur.     c)            What could you conclude about Ruth’s capacity to adjust to school from the first administration of the BASC-SRP subscales relating to school maladjustment?   Ruth’s capacity to adjust to school from such school maladjustment composite from such BASC-SRP subscales on first administration indicate that there is enough incidence of maladjustment at all as there shows a T score 62 showing a negative or undesirable characteristics when she was aged 13 and up. It can be that family problems on the first administration have been present and evident in Ruth’s life as a student.    d)           What could you conclude about Ruth’s clinical maladjustment from the clinical subscales at the first administration?   Thus, on Ruth’s clinical maladjustment from the clinical subscales at the first administration entail that there may be certain occurrence of problem formation as there can be presence of such positive characteristics although Ruth was in circumstance of her parents having divorced as the composite score shows 53 mark outcome     e)            What could you conclude about Ruth’s capacity to adjust to school from the second administration of the BASC-SRP subscales relating to school maladjustment?   Ruth’s capacity to adjust to school from such school maladjustment composite from the BASC-SRP subscales on second administration do indicate that there can be presence of school maladjustment as the score reached to 47 mark which Ruth has been affected by the situation of her parents as well as the fact that she transfer to new school imposes high risk to cope up any form of maladjustment mostly to the immediate environment she belongs,.     f)             What could you conclude about Ruth’s clinical maladjustment from the second administration?   Then, for Ruth’s clinical maladjustment recognition from clinical subscales in the second administration is still evident even though some indicators of the composite may indicate negative characteristics pointing to school stress in particular and even under problems within family there is still positive characteristics shown into Ruth’s attitude towards school and in general.     g)           In a couple of sentences write what you could conclude overall from the BASC and K-BIT results, considering both administrations.   Both from the BASC and K-BIT outcomes upon considerations of the two different test administrations therefore, it can be that the K-BIT do recognize such intelligence measure from knowing the capability to solve problems and can’t affected by certain experience and education domain along with levels of knowledge. Showing that intelligence is changing phenomenon that may need diverse approach for assessment. Thus, Ruth performance at school can be more complicated from psychological operations and are better to convert and use information, the test is highly reliable and has great validity. Aside, BASC-SRP is a good measure as utilize to evaluate Ruth’s perceptions and feelings about school from within composition of her own behaviour and there implies how Ruth adopts to the environment directly as manifested from within actual process in which she is connected to the rationality of herself and her composed attitude as individual.     h)           In a paragraph outline any limitations of your conclusions: in what ways would you qualify your conclusions in any report to the father?   My conclusions is only limited to what is free or given into the situation for further assessment of Ruth’s case and that the two tests does really help to understand better from within sides and that Ruth is still a normal student that can be affected by familial issues but has tendencies to easily cope with those situations, points of recovery and counseling can still be okay under certain instances. The two tests administered were effective upon showing certain categorical level of Ruth’s behaviour from such interpretative reliability aspect and stance.     Margaret’s Case   a)    What would you conclude from the BDI about Margaret’s level of depression?   The BDI provide measure of severity of symptom rather than diagnosis integration as it can be inappropriate to ascertain diagnosis of depression solely on basis of inventory. Margaret’s level of depression is in high mark from the BDI scoring 40 at highest level as such factors can affect her depression state such as sadness, punishment feelings and self-dislike. Thus, it can be due to the past experiences she had encountered.   b)   Considering the MCMI data as well as the BDI what could you conclude about a possible mood disorder?   Yes, there can be a possible mood disorder can be seen from such BDI and MCMI assessments as there have been indicative assumptions that Margaret can show signs of such like, having fear to commit into a relationship after a failed relationship and what type of family orientation she has can be serve as a main factor for the disorder to come in. Thus, clinical scores exceed the maximum score even if average outcomes were shown on the scale rank.     c)    From the MCMI data what would you conclude about other possible clinical syndromes?   There can be clinical syndromes possible if based from the MCMI data, I can conclude that such scores present valid points for other existing clinical syndromes that are not indicated upon testing Margaret from within such category as there can be such twenty two personality disorders and clinical syndromes used for Margaret who is undergoing psychiatric assessment upon developing treatment approach that takes account in patient’s personality style and coping behavior and guiding treatment decisions based on Margaret’s personality pattern.   d)   Are any personality disorders suggested by the MCMI data?    There can be such other personality disorders in suggestion linking to the MCMI data such as stress disorders as well as disturbance of conduct and antisocial personality disorders as the test are being support by the Diagnostics and Statistical Manual approach as based on the MCMI norms and standard set up such as subjects representing various DSM-III and DSM-III-R diagnoses.   e)    How does your provisional diagnosis fit with the case history material?  That is, can you see the roots or early signs of some issues in the case material?     The provisional diagnosis fit with case history material in such a way that family history of medical and or mental heath can be a consideration in indicating types of disorders seen within the individual and that personality disorders are known in such areas and domains that needs attention for proper action. There are early signs known within Margaret’s situation as such she has family background of family having roots of mental disorder, having history of psychological problem in the mother side as her grandmother has been diagnosed of schizophrenia and her grandfather did attempted suicide many times.     f)     What other kinds of tests would you consider administering or what other information would you seek to clarify the diagnosis and why?   The other tests as showed below are possible to administer that are connected to Margaret’s case can be the following:   -       Advanced Multidimensional Personality Matrix (Abridged, Personality Profile) -       Depression Test -       Anger Test -       Mental Toughness (Hardiness) Test -       Risk Taking Test -       Self-Esteem Test -       Optimism/Pessimism Test -       Values Profile     In, Psychological Tests Lists At: http://www.psychtests.com/tests/alltests.html For other information wished to clarify for diagnosis can be the evidence of interim tests outcomes serving as proof of the scores attained from within the two assessment tool as administered accordingly.   Credit:ivythesis.typepad.com

WRITTEN DIAGNOSTIC AND TESTING EXERCISE

WRITTEN DIAGNOSTIC AND TESTING EXERCISE There has been underlying interests imposing incidence of personality disorders as ...