abnormal psychology, clinical psychology, Cross-Cultural Psychology, Environmental Psychology, Personality Psychology, social psychology, Uncategorized

Substance Abuse Disorder

Case Study 2

Diagnosis:  Substance Abuse Disorder

Background

  • Outline the major symptoms of this disorder.
    • Substance Abuse Disorder is signified through psychological, cognitive, and behavioral indicating the individual continued use despite problems associated with substance use (American Psychiatric Association, 2013).   Changes in brain circuits, persistent after detoxification which manifests through repeated relapse and substance cravings triggered by environmental cues (American Psychiatric Association, 2013).  Substance abuse disorder is diagnosed based on some categorical criteria.  The first group of criteria, impaired control, explains the individual may increase usage over a longer period of and be unable to cut down usage even though expressing a desire (American Psychiatric Association, 2013).   Additionally, a great deal of time is spent attaining the substance which may cause the individual to incorporate activities around the substance and develop cravings for the substance (American Psychiatric Association, 2013). The second group, social impairments, identifies recurrent use is hindering daily life such as work, school and home combined with continued use despite deficits in interpersonal relationships (American Psychiatric Association, 2013).  Important and enjoyable activities may be given up for the substance as well as familial withdraw for the use of the substance (American Psychiatric Association, 2013).

The third group, risky use, includes the failure to abstain from the substance despite, physical or psychological impairments caused by the substance (American Psychiatric Association, 2013).  The fourth group, pharmacological criteria, is defined as a marked tolerance for the substance and the presence of withdrawal syndrome (American Psychiatric Association, 2013).  At this point, the individual likely no longer continues use for the effect of the substance, rather avoid the effects of withdrawing as the body has now become dependent on the substance for the feeling of normality (American Psychiatric Association, 2013).  However, according to the DSM-V, individuals who use and become dependent on a substance solely for medical treatment should not be diagnosed with substance abuse disorder (2013).  Additionally, Substance Abuse disorders are diagnosed by severity according to specific coding for a specific substance (American Psychiatric Association, 2013).

  • Briefly outline the client’s background (age, race, occupations, etc.).
    • Bobby is a thirty-one-year-old female who claims sobriety for ten years.  She lives in an apartment with her five-year-old son, Tyler and her boyfriend.  April 10, 1989, Bobby was diagnosed with HIV although she does not know how she contracted the virus.  She does continue to work a part-time job at this point.  Bobby established that her issue began at nine years old when she desperately desired her mother who was inconsistent in her life.  Her mother was an addict and very sporadic.  She remembers being sexually abused by her stepbrother from the age of nine to fifteen.  At the age of nine, she began doing things for attention from her father such as attempting suicide.  She recalls the attention she received from her father was a “slap in the face” or “a knee in the stomach.”  However, later in the interview, she claimed not to have experienced abuse from her father, rather witness domestic violence towards her mother by her father.  By twelve she was smoking cigarettes and drinking alcohol.  Her father moved her three times in Tucson, assuming this gave her a sense of instability, her acting out progressed.  By thirteen she was smoking pot and at fourteen was drinking vodka daily.  At fifteen, Bobby dropped out of school, and her life revolved around, “partying” and sex (McGraw Hill Higher Education, 2007).

At sixteen Bobby ran away from her father’s home hitchhiking to Iowa and experienced her first rape and began using cocaine, speed, and acid. She started living with her mother, in Portland, who introduced her to heroin through a cotton ball as a chew for a mouth infection.  Her mother was busy with her life, so Bobby took to the streets and began prostituting, shooting up, and went through an abusive relationship.  By twenty, Bobby was using 2.5grams of heroin and 1gram of cocaine a day, was prostituting in the street almost twenty-four hours a day, and entertaining bisexual relationships.  She felt consumed by her substance abuse and would turn tricks with a partner to make more money (McGraw Hill Higher Education, 2007).

When Bobby was twenty-one, she was sent to prison for the second time.  A diagnosis of HIV soon followed which brought her to the realization she was going to die yielding her to sobriety.  Although she maintains sobriety from her adolescent lifestyle, Bobby admits to smoking pot to alleviate side effects of her medications, occasionally drink and have a methadone dependency which allows her to get out of bed each day.  However, she said choosing to smoke pot was difficult because it crosses the line of addiction.  Bonny maintains she is fearful of returning to addiction even though she has no desire.  It is a battle each day for her, but she is adamant on helping others turn their life around or prevent addiction in potential users.  She has returned to school for medical office assisting (McGraw Hill Higher Education, 2007).

 

 

  • Describe any factors in the client’s background that might predispose him or her to this disorder.
    • Evidence suggests that genetic factors influence the risk of substance abuse disorders with inheritability at fifty percent or more ((Dick, Ph. D. & Agrawal, Ph. D., 2008). Additionally, twin studies suggest dependence is determined by a combination of genetic and environmental factors (Dick, Ph. D. & Agrawal, Ph. D., 2008).  Both facts imply Bobby has a genetic predisposition for the development of substance abuse disorder.  According to an article found on the NIDA website, females who were sexually abused as children were three times more likely to develop a substance dependence as adults (Zickler, 2002), supports the effect of the sexual abuse and intercourse experienced by Bobby via her step brother from age nine to fifteen.  Additionally, Bobby exposed that she believed she felt worthless, unloved, and unwanted.  To attempt to receive what she desired and needed, she began to reach out in the world and gain acceptance from anyone who would oblige it.  She found comfort in using drugs and drinking and felt as if she knew everything which directed her toward leaving to her mother.  Her mother then exposed her to other drugs building upon the dependence she had already influenced herself which is consistent with the environmental factors discussed in twin studies earlier (McGraw Hill Higher Education,  2007).

Observations

  • Describe any symptoms that you have observed that support the diagnosis. You can include direct quotes or behaviors that you may have observed.
    • Bobby exhibited impaired control through her behaviors such as prostitution and the evolution of her experimentation with drugs into dependence.  Social impairments were evident in her abusive relationship, separating herself from her father, and dropping out of school after planning her future as an astronaut for the Air Force.  Shooting up, prostitution, and bisexual relations identify with risky behavior as explained by the DSM-V as she exposed herself to sexually transmitted diseases and contracted HIV.  She met the fourth criteria due to the high dosages she needed at the time she chose sobriety.  Additionally, Bobby currently has an addiction to methadone, claiming she takes it to get out of bed in the morning.  She also exposed that she currently smokes marijuana, although she uses it for medicinal purposes, it was understood she obtained it illegally and became defensive when explaining herself.  She also admitted to drinking socially from time to time which implies that she is still triggered in the environment.  She fears to relapse in her addiction, but the implication is that she has not completely broken the addiction, rather substitutes through prescription and medicinal purposes.
  • Describe any symptoms or behaviors that are inconsistent with the diagnosis.
    • The DSM states that an individual should not be diagnosed with a substance abuse disorder if the dependency evolved directly from medical treatment (American Psychiatry Association, 2013).  Due to the methadone being prescribed for the pain she endures from neuropathy caused by HIV drugs, currently, she would not fall under the substance dependence criteria.  However, she did not distinguish if the methadone was originally prescribed as a detoxification tool or for medical treatment.
  • Provide any information that you have about the development of this disorder.
    • Bobby claims she was desperate for love and attention which prompted her negative behavior.  In her mind, at the time, any attention was good attention, and she sought it at all extremes.  She was genetically predisposed through her mother who also fought heroin addiction.  She moved three times in a short period which implies an unstable lifestyle in childhood which is stressful and holds potential to ignite negative behavior.  Additionally, she endured sexual abuse heightening her risk for developing a substance dependence in adulthood (McGraw Hill Higher Education, 2007).

Diagnosis

  • Did you observe any evidence of general medical conditions that might contribute to the development of this disorder?
    • Bobby’s current usage is due to the pain and sickness she endures while battling HIV.  However, it appears that childhood depression caused by family dysfunction and abuse led her to develop the disorder.  She was desperately looking for a place in the world to fit in and be loved.
  • Did you observe any evidence of psychosocial and environmental problems that might contribute to this disorder?
    • Bobby claimed as a child she just wanted to be loved.  However, looking back she believed she was unhappy due to an absent mother and feelings of abandonment brought on by her father who fostered more attention toward his stepdaughter.  She chose the crowd of people who accepted her with her flaws and had ways to make her feel better through the use of alcohol and illicit drugs.  At sixteen she was raped and at that point, it seems her dependence heightened as she claimed using heroin dulled the emotional pain she experienced (McGraw Hill Higher Education, 2007).
  • As per your observations, what is the client’s overall level of safety regarding the potential harm to self or others (suicidality or homicidality)?
    • Bobby attempted suicide twice seeking attention and love from her father.  She was scared by the death sentence she received being diagnosed with HIV and decided to change her lifestyle.  She claims she does no want to die because she wants to watch her son grow and be a mother to him, so he does not experience what she did (McGraw Hill Higher Education, 2007).  However, it is imperative to use caution.  Bobby has a terminal disease that makes life difficult and painful for her.  As she recalls memories of her past, she becomes very emotional especially memories about her health status.  If she falls ill again, she holds potential for harming herself because she may fear her son watching her die from AIDs.

Therapeutic Intervention

  • In your opinion, what are the appropriate short-term goals of this intervention?
    • Bobby needs to focus on healing from living with HIV.  She fears the future or the thought of the future because she feels doomed to death.  If Bobby can view the future in a positive manner, she will have more success at battling her health and raising her son.  The development of a goal plan will give her a reason to keep fighting.  The plan should include medical, personal, educational, and her son’s milestones.  Once Bobby is able to accept her past and view the future, she can begin a full recovery.

Bobby should continue working with inmates.  Telling her story to others is part of the healing process and will allow her to see clearly what was void to her before.  It serves, in a sense, as a group therapy.  Walking into the prison is a reminder of the potential behind relapse and telling her story can reach someone else fulfilling her desire to help others.

  • In your opinion, what are the appropriate long-term goals of this intervention?
    • Bobby admits to continued use of Marijuana, alcohol, and an addiction to methadone.  Although she explains, the above are used for medicinal purpose, she appears emotional to her past.  When speaking of the past, one should be able to do so with confidence that emanates the pleasure and peacefulness of the change.  I don’t think Becky is there yet, hence her continued usage, and possibly replacement addiction.  Bobby should ween off the methadone and replace with a healthier pain management strategy.  Additionally, Bobby needs to come to terms and accept the mistakes that she made in order to have a positive future.  A healthy psyche leads to biological health.

It is also important that Bobby continue her education goal.  She desires to be needed, wanted, and make a difference in someone else’s life.  Continuing her education will give her a sense of accomplishment and boost her self-esteem and allow her to set the positive example she wants for her son.  Additionally, helping in the HIV/AIDs field as she desires will help her better accept her life in its current state, despite the hardship.

  • Which therapeutic strategy seems the most appropriate in this case? Why?
    • A behavioral therapeutic approach would allow Bobby incentives to maintain sobriety.  That incentive is a longer, healthier life for her son.  Currently, Bobby suffers from HIV which has led her to a drastic life change.  However, Bobby still has addictive tendencies as seen with her current usage.  Although she has eliminated the lifestyle and the addiction that led her to HIV, she dabbles with other drugs and alcohol and has developed a new addiction to a prescription.  Behavioral therapy aims to modify attitude and behavior (“NIH”, 2012), such as the thought of using is okay because it alleviates medical symptoms.  Additionally, Bobby will learn coping skills for times of stress or environments that trigger cravings (“NIH”, 2012), such as drinking in social settings.
  • Which therapeutic modality seems the most appropriate in this case? Why?
    • The harm reduction model discussed in the treatment section of the interactive seems to be the most appealing for Bobby.  In the Harm-Reduction Model, the individual is taught that relapse is not a personal weakness, rather caused by the situation (McGraw Hill Higher Education, 2007).  When an individual is led to believe their fall is from a personal deficit, it may cause them to believe they are not able to conquer their demon which triggers the addictive behaviors to reignite.  In the Harm-Reduction model, the experience of relapse is examined to identified what caused the slip and coping skills for the scenario are developed to avoid repeat relapse in the future (McGraw Hill Higher Education, 2007).  However, there is a drawback, relapse rate is higher (McGraw Hill Higher Education, 2007).  However, as found in conditioning, repetitive negative reinforcement deters the behavior and eventually the individual is strong enough to beat the addiction.  Using this model can help Bobby recover from her methadone addiction and permanently release her from marijuana and alcohol use.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Dick, Ph. D., D. M., & Agrawal, Ph. D., A. (2008). The genetics of alcohol and other drug dependence. Alcohol Research and Health, 3(2), 111- 118. Retrieved from http://pubs.niaaa.nih.gov/publications/arh312/111-118.pdf

Johnson, A. B., Gentile, J. P., & Correll, T. L. (2010). Accurately diagnosing and treating borderline personality disorder: a psychotherapeutic case. Psychiatry (Edgmont)7(4), 21–30.

McGraw Hill Higher Education. (2007). Faces of abnormal psychology interactive [Multimedia]. Retrieved from McGraw Hill Higher Education, Maladaptive Behavior & Psychopathology | FP6005 A01 website.

NAMI. (2016). Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder

NIH. (2012). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapiesNIH. Retrieved from http://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

Nolen-Hoeksema, Susan. (12/2013). Abnormal psychology, 6th edition. [VitalSource Bookshelf Online]. Retrieved fromhttps://digitalbookshelf.argosy.edu/#/books/1259316335/

Zickler, P. (2002, April). Childhood sex abuse increases risk for drug dependence in adult women. NIDA, 17(1),. Retrieved from http://archives.drugabuse.gov/NIDA_Notes/NNVol17N1/Childhood.html

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abnormal psychology, clinical psychology, Cognitive psychology, Cross-Cultural Psychology, Environmental Psychology, Maladaptive psychology, Personality Psychology, Uncategorized

Case Study: Attention Deficit Hyperactivity Disorder

Case 1:  Attention Deficit Hyperactivity Disorder (ADHD)

Background

  • Major symptoms of this disorder.
    • According to the DSM 5, ADHD is a pattern of “inattention and / impulsivity” that affects day to day functioning (p. 59).  Inattentiveness manifests through failure to follow or focus on tasks and exhibiting disorganization (American Psychiatric Association, 2013).  Hyperactive behavior manifests as excessive motor activity such as fidgeting, talking, or the inability to sit still when inappropriate (American Psychiatric Association, 2013).  Excessive impulsivity refers to actions made without forethought that may risk safety as a way to gain a reward or the inability to delay personal gratification (American Psychiatric Association, 2013).   Impulsive behaviors may be perceived as socially intrusive and void of long term considerations (American Psychiatric Association, 2013).  However, it is important to note that all symptoms must not manifest due to defiance or lack of comprehension, must be inconsistent with the development level of the individual, have a manifestation before the age of twelve, and be present in two or more settings (American Psychiatric Association, 2013).
  • Client’s background
    • David is a sixteen-year-old, Caucasian, high school sophomore.  He lives in a single parent household and is raised by his mother.  David presented as a “regular” teen who likes sports and video games.  He claims to have a girlfriend he enjoys spending time with her.  Additionally, David takes Wellbutrin and Ritalin throughout the course of the school year, but during the summer he remains medication free.  David claims to have always been hyperactive which led to teacher complaints in elementary school.  David’s mother loves him, but has allowed his negative behaviors to continue their evolution through her lack of discipline and failing to enforce the vitality of passing grades.  David seems to have no schedules or daily routine chores set in play, rather spends hours playing video games and watching television.  His mother asks little of him and when she does, he has no consequences for not doing what was asked.  When medicated, David tends to do better in school and retains some focus, however, he does not like that the pills make him “lazy and anti-social” (McGraw Hill Higher Education, 2007).
  • Possible Predispositions
    • Although genetic factors, especially inheritable traits from the father, play a part in the development of ADHD (McGraw Hill Higher Education, 2007)., there was no information disclosed on medical history, therefore a predisposition cannot be acclaimed in David’s case.

Observations

  • Symptoms
    • Throughout the course of the interview David was in constant movement.  He spoke with hands and fidget in and with his chair.  His thoughts were unaligned as he began with one topic and moved to the next and back to the original topic (McGraw Hill Higher Education, 2007).  Consistent with the DSM-5 development and course, David claimed to be hyperactive as far as his memory would allow him to recall.  David admits that he has difficulty focusing on tasks or schoolwork demonstrating symptoms of inattentiveness as the DSM-5 reports as a primary symptom (American Psychiatric Association, 2013).  ADHD inhibits individuals in school performance, and social relationships which may letter cause the development of antisocial personality disorder in adulthood (American Psychiatric Association, 2013) which solidifies David’s struggles in school and his lack of friendships.
  • Symptoms or behaviors that are inconsistent with the diagnosis.
    • David plays several hours of video games implicating that a video game can hold his attention.  He actually claimed that he can beat and entire game in one sitting by the time his mother woke up in the morning (McGraw Hill Higher Education, 2007).  This fact is inconsistent with the DSM-5 criterial symptoms which claim a very short attention span and easy distractibility in addition to the inability to quietly indulge in leisure activity for a period of time (“Centers for Disease Control and Prevention”, 2016).   The “Center for Disease Control and Prevention” website claims individuals are often unable to listen when spoken to (2016), however, David followed along in the conversation and answered questions promptly.  Although he tended to lose track of his thoughts throughout his answers, he often jumped topics, but ultimately returned to his initial thought (McGraw Hill Higher Education, 2007).  Another aspect that seemed odd was David’s claim that when reading, words would begin jumping around the page and become blurry causing him to lose focus and attention, but this was not relatable to the DSM-5 criteria (McGraw Hill Higher Education, 2007).
  • Development of this disorder.
    • The DSM-5 clarifies that ADHD is most identifiable in elementary school as inattention becomes more prominent (American Psychiatric Association, 2013) resulting in educational impairment and teachers identifying behavioral issues to parents as David discussed in the interview. However, it would be interesting to l earn the mother and father’s medical and mental health history.  The DSM-5 also explains family interaction has no bearing on the development of ADHD, but may influence the disorders course or development of secondary conduct disorders (American Psychiatry Association, 2013).   There is little family time for David and his mother and the void is filled through gaming and lack of discipline and reasonable expectations from the mother.  It is possible that the lacks and void filling encouraged the course of ADHD to heighten and possibly lead to worse symptoms of the disorder.

Diagnosis

  • Medical History
    • There was no medical history exposed in the interview to validate a contribution to David’s ADHD.
  • Psychosocial and environmental problems
    • David is being raised by a single, overwhelmed mother who has little time for him.  However, the interview revealed “most of the time” he lives with his mother, implying there is another figure involved in David’s upbringing that is not disclosed in the interview (McGraw Hill Higher Education, 2007).  His mother tends to give him tasks, but fails to follow through with any type of recourse for his negative actions or failure to complete a task (McGraw Hill Higher Education, 2007).  This was evident when she accepted his failing math and directed him to focus on another subject rather than seek help to aid in him learning the material (McGraw Hill Higher Education, 2007).  She does not ask him to do much giving the persona that she reinforces the negative behavior and inability to focus on a task or topic.   According to the narrator, it is common to see children from single parent households present with ADHD (McGraw Hill Higher Education, 2007).  It is a typical routine for David to play video games which appears to be a distraction from other aspects of life such as schoolwork and chores (McGraw Hill Higher Education, 2007).  Additionally, David feels as if many teachers just give up on him rather than attempt to help him improve in learning (McGraw Hill Higher Education, 2007).
  • Client’s overall level of safety regarding potential harm to self or others (suicidality or homicidality)
    • Regarding David’s safety, he appears stable.  However, in the course of the interview, he admitted to being taunted by other kids and seemed to have little knowledge about ADHD (McGraw Hill Higher Education, 2007).  He claimed to have friends and a girlfriend, but appeared to be socially awkward and compared himself to another male who was “worse off” than himself (McGraw Hill Higher Education, 2007).  Due to his comparisons and the reactions of others to his demeanor, it is essential to closely monitor his self-esteem.  Additionally, he does not always make the best choices and his impulsive behavior holds potential for harm even if he does not intend hurting himself (McGraw Hill Higher Education, 2007).  According to the DSM-5, as individuals enter early adulthood the risk of suicide attempt increases especially when comorbid with mood, conduct, or substance abuse arises (American Psychiatric Association, 2013).  David will soon be entering adulthood and he claims irritation and frustration with certain aspects of his life.  Early intervention of possible suicide ideations would reduce the likelihood of David developing suicidal potential.
  • Cross-cultural issues that may affect the differential diagnosis?
    • According to the interview, ADHD occurs in about five percent of the population and although it occurs across all cultures, it is most prevalent in the United States (McGraw Hill Higher Education, 2007). Additionally, David is male and statistically more prone to a diagnosis of ADHD than female (American Psychiatric Association, 2013).

Therapeutic Intervention

  • Short-term goals of this intervention
    • It is essential to reduce David’s video game activity and increase his number of chores.  Setting up a chore chart or goal plan with David will help him remember what needs to be completed and by when.  The chart and schedule can be utilized for schoolwork, chores, and recreation as it will clearly define expectations.  Another short term goal would be to improve grades in school by incorporating a daily homework schedule and seeking out external tutoring programs to help accommodate his problem areas such as math.  Additionally, David should join sports team’s year round as this will help him focus his energy in an area he loves and build social skills and develop a teamwork effort.
  • Long-term goals of this intervention
    • David needs behavior modification to address his impulsive behaviors and replace them with thought out actions and reactions.  As a minor, his mother has a major role in David’s life.  His mother needs to learn techniques of proper discipline and basic parenting skills that provide an environment that includes rewards for positive behavior and consequence to negative behavior.
  • Therapeutic strategy
    • The psychosocial approach to ADHD includes Direct Contingency Management focuses on a direct approach for rewarding desired behavior (Brinkman & Epstein, 2007).  David has not experienced consequences for his behaviors, instead his mother just accepted whatever he did.  Encouraging good grades and completion of homework assignments and chores with a reward would allow David to perceive that good behavior and deeds earns positive feedback and he carries potential to do good.  Clinical Behavior Therapy will allow David’s mother to learn basic parenting skills to help manage ADHD in day to day activity and settings (Brinkman & Epstein, 2007).  Teaching David’s mother the proper skills will allow her to create an environment that rewards desired behavior hopefully implanting a drive in David to take on responsibility that will allow him to use some of the excess energy he fights (Brinkman & Epstein, 2007).  Additionally, David should continue his medications as they allow him to focus and have proven an improvement in school.  However, it may be necessary to alter medications as he may have built up a tolerance and the medication is not as effective as it once was.
  • Therapeutic modality
    • A multimodal approach of Psychotherapy in conjunction with medications seems to be the most appropriate modalities in David’s case.  A study of the Multimodal Treatment approaches conducted by Brinkman and Epstein which included only direct contingency management and Cognitive Behavioral Therapy reported 34% of the children reported a remission of symptoms (Brinkman & Epstein, 2007).  The study concluded that 56% of the children who were treated only with medication reported positive benefits to the medication, although 50% reported mild side effects (Brinkman & Epstein, 2007).  In a combination treatment of both medication and therapeutic services, 68% of the children reported remission of symptoms after fourteen months (Brinkman & Epstein, 2007).  However, it is important to note that although these statistics have a wonderful turnaround, both patient and parent, must choose goals that align with both desires of outcome as well as both must be willing to stick to the regimen to have the most effective results (Brinkman & Epstein, 2007).

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Brinkman, W. B., & Epstein, J. N. (2011). Treatment planning for children with attention-deficit/hyperactivity disorder: treatment utilization and family preferences. Patient Preference and Adherence5, 45–56. http://doi.org/10.2147/PPA.S10647

Centers for Disease Control and Prevention. (2016). Retrieved from http://www.cdc.gov/ncbddd/adhd/diagnosis.html

Chien, W. T., & Yip, A. L. (2013). Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments.  Neuropsychiatric Disease and Treatment9, 1311–1332. http://doi.org/10.2147/NDT.S37485

Clubhouse International. (2016). Retrieved from http://www.iccd.org/whatis.html

McGraw Hill Higher Education. (2007). Faces of Abnormal Psychology Interactive [Multimedia]. Retrieved from McGraw Hill Higher Education, Maladaptive Behavior & Psychopathology | FP6005 A01 website.

MacGuire, P. A. (2000, February). New hope for people with schizophrenia. American Psychological Association, 31(2), 24. http://www.apa.org/monitor/feb00/schizophrenia.aspx

 

 

The Answered Patient (2015).  Schizophrenia overview [Video file]. Retrieved from BehaveNet.com website: http://behavenet.com/schizophrenia

 

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Personality Psychology

Dispositional Theory

Psychologists, as with many others, have been intrigued for thousands of years about the concepts and drives of personality and what makes individuals react in certain manners.  Personality is the study of the individual differences of thinking, feeling, and behavior and how all the parts of a person blend creating a whole (APA, 2015).   Ironically, it remains, that psychologists cannot come to a consensus on the definition of personality. Personality appears as a mask that specifies the individual attributes of individuals as they coast throughout the lifespan and evolve from birth to death (Feist, 2005).  Dispositional and biological theories of personality expand on the basic theories to develop ideals based on the conscious, genetic and biological understanding of personality.

Dispositional Theories

Dispositional psychology identifies the conscious motivations identified in explaining personality (Feist, 2006).  Gordon Allport believed that personality traits are individualized, unique characteristics that evolve within a person throughout the lifespan (Boeree, 1998, 2006).    As people tended to confuse these traits as physical similarities within one another, Allport declared them as dispositions.  Dispositions are definitive consistencies in behavior (Boeree, 1998, 2006).    Gordon Allport thought that mentally healthy adults were able to make conscious decisions and understand his or her behavior along with behaviors cause and effect processes (Feist, 2009).  Allport’s conscious motivation theory stated that individuals are responsible for their individual behavior and development (Feist, 2009).  The conscious motivation theory brought about truth in developing Allport’s belief in functional autonomy, or that present behavior is not influenced by past experience (Boeree, 1998, 2006).  Allport based most of his research on speculation rather than scientific research causing weaknesses in his theories (Feist, 2009).  Although his theory could not be proven unfalsifiable, his writings of his observations opened the door for future research bases (Feist, 2009).  Although the unconscious was acknowledged, his theory left openings for explanations of unconscious behavior that could be integrated into the explanation of personality (Feist, 2009).  Most importantly, Allport stepped outside the normal belief and studied the conscious motives of behavior allowing individuals to be held responsible for their actions (Feist, 2009).

Biological Theories

Biological psychology claims that humans are biological creatures that evolve from genetics, cause us to eat for survival, and behave because of the neuronal firings that throughout our brain (Feist, 2009).  These theories, just like dispositional theories seek to identify consistencies in individual differences.  However, biological theories tend to delve into the biological aspects of personality such as genetics and evolutionary origins (Feist, 2009).  Biological psychologists claim that personality is developed through genetics derived from evolutionary history and is impacted by hormones and neurotransmitters (Feist, 2009).  Biological psychology created a bridge between psychology and biology as it seeks to explain how the brain contributes to behavior (Feist, 2009).  Explanations of individual differences extended beyond the environment of the individual and included evolutionary support (Feist, 2009).  Biological research opened doors for future studies on personality.  However, biological psychology emphasizes the genetic aspect of personality fragmenting the theories which leaves unexplained holes (Feist, 2009).  The fact that these theories focus on genetics and evolution of culture leaves little availability of future adaptations of personality (Feist, 2009).  The fragmented ideals allow for further research in the future to fill the gaps.

Similarities and differences

Both, dispositional and biological psychologists aim to find consistencies in behavior and individual differences (Feist, 2009).  However, biological psychology mandates personality evolves over time through generations deeming that there are genetic inconsistencies in personality from individual to individual (Feist, 2009).  Dispositional theorists claim that personality is developed through traits called dispositions.  The common traits are characteristics that are held by a certain group of people such as culture, but within a common trait is a disposition unique to one individual (Feist, 2009).  Biological psychologists mandate the primary structure of personality is built from genetic structures that evolve and adapt over time whereas dispositional psychologists maintain traits are consistent structural bases of personality (Feist, 2009).  Both theory types believe that personality is built from an internal mental structure that regulates consistencies and dispositions within a person.  Dispositional theorists believe individuals behave at a conscious level, but biological theorist’s behavior occurs at an unconscious level (Feist, 2009).

Big Five Personality Test

Originally, personality contained 4,000 traits which was entirely too lengthy.  As researchers began to dig, they narrowed it down to three major characteristics, but this was too broad.  Paul Costa developed a Five-Factor model of personality consisting of different characteristics that make up personality (Feist, 2009).   A person who is eager to please they may seem agreeable.  One who looks for outside interaction shows signs of extroversion.  An individual who seeks new experiences elicits openness.  A cautious individual is conscientious.  Finally an individual who tends to be pessimistic and elicit negative emotions elicits neuroticism.  The Five-Factor personality test consistently varies for individuals, often allowing individual’s to fall between extremes.  The factors are heritable and stable for a period of time.  It is believed that the factors have adapted throughout evolution, but are universal to all humans.  The test can accurately depict an individual’s typical personality which is useful in therapy as well as education and career.  Although these characteristics may not affect an individual’s personality, they may have an effect on interpersonal relationships.  An individual who elicits openness and extroversion may create healthy, stable relationships.  However, an individual who elicits neuroticism and conscientiousness may have difficulty developing relationships with others.  An employer may be quicker to higher the first individual as opposed to the second even if the second is more qualified than the first.

Conclusion

Psychologists consistently seek learn what makes individuals who they are and how they behave.  Dispositional psychology takes a conscious approach of explaining personality through individual dispositions, or differences.  Biological psychology takes the stand point that personality is heritable through genetic makeup that evolves over time.  The Big Five-factor test is an attempt to decipher a personality type based off five core characteristics of personality.  Though much research has been completed, researchers continue to open doors to further explain personality.

References:

American Psychological Association. (2015). Retrieved from http://apa.org/topics/personality/

Boeree, Dr. C. G. (1998, 2006). Personality Theory. Retrieved from http://webspace.ship.edu/cgboer/allport.html

Feist, J., & Feist, G. (2009). Theories of Personality (7th ed.). New York, NY: McGraw Hill.

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Personality Psychology

Sigmund Freud’s contribution to Psychodynamic Theory

– Sigmund Freud had a phenomenal mind which laid the foundation of the psychodynamic theory.  Freud’s belief that conflict in childhood caused conflict in adulthood was the initial layer of the psychodynamic theory.  He pointed out the vitality of successfully completing the stages of development and the detriment that may occur if the stages of development were not successfully completed.  Freud’s theory grasped the attention of several other behaviorists who took his lead and edited it to become a generalized theory appealing to almost every aspect of personality and behavioral development.  Some of his beliefs were omitted and others were expanded to include an array of explanations of an individual and the reasons why they act, think, and feel as they do.

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Humanism, Personality Psychology, Psychodynamics

Personality Theory Analysis

Throughout the time of the human existence, individuals have continuously exerted effort to figure out who they are.  An exact science to precisely identify individuals is non-existent, but researchers continue to probe deep into the human mind in combination with observing behavior to determine the causes of human personality.  The study of personality includes identifying the individual differences in thought, feelings, and behavior (APA, 2015).  Additionally, personality psychologists attempt to learn how all different parts of a person integrate to produce the unique individuals in society (APA, 2015).  Personality is exclusive to each and tends to remain consistent throughout the life and has, therefore, has become psychologist’s primary focus to explain behavior.  Several theories attempt to explain the development of personality and its effect on behavior, but the two most contradictory approaches are the psychodynamic approach and the humanistic approach.

Personality

The fundamental characteristics of personality include consistent thought patterns and traits. Psychological and physiological constructs which impact behavior, action, personal expression, thoughts, and social interaction comprise personality (Feist, 2009).  Personality, described through temperament and character, is exclusive to the individual.  Temperament is composed of a biological basis and described emotions within a person (Feist, 2009).  Character is the personal attributes of self-based on morals, ethics, will power, and integrity (Feist, 2009).

Humanistic Approach

The humanistic approach to personality emphasizes free will and individual experience. Individuals exercise free will through the choices made in life and the consequences of those choices.  Humanism focuses on the person as whole, rather than just a certain aspect of the individual (McLeod, 2007).    They believe that the individual behaviors originate from inner feelings and thoughts of self.  The primary focus of this approach is self-concept and self-actualization. (McLeod, 2007).  Self-concept is who an individual thinks they are.  Self-actualization refers to the ideal self, or who an individual wishes they were (McLeod, 2007).  The humanistic approach is an optimistic approach that views individuals as good with an innate desire to reach their maximum potential while making others’ lives better (McLeod, 2007).  This approach declares individual continually strive for life improvement through obtaining set goals allowing the individual a sense of satisfaction and achievement.

In an effort to learn what motivates individuals, Abraham Maslow develops the hierarchy of needs.  Maslow’s hierarchy emphasizes that individuals are not necessarily motivated by unconscious desires or rewards, but to achieve meeting needs.  His hierarchy is set up in five stages that are necessary to reach self-actualization. Psychologists believe that individuals must meet all needs in the hierarchy before moving on to the next need.  Failure to meet the needs results in the hindrance of later development (McLeod, 2007).  An individual’s primary need is to satisfy physiological needs that are necessary for survival (Feist, 2009).   Once the survival need is fulfilled, the individual can advance to the next need.  Once the lower level needs are satisfied, the individual has the potential of self-actualizing, meaning he or she has reached maximum potential and has found a clear understanding of themselves and their place in the world.  However, according to Maslow, very few people reach this level in their life span (Feist, 2009).

Psychodynamic Approach

Sigmund Freud founded the psychodynamic approach to personality.  It is a group of all the human functioning theories combined into one.  The psychodynamic approach is based on the interactions of unconscious drives and motives that produce behavior (McLeod, 2007).  Freud believed that all behavior has a cause, though one may not be aware of the unconscious motivations (Rana, 1997).  Behavior and feelings are affected by unconscious motives, and early childhood experience affects adult behavior.  It is the unconscious drives and motivations that establish what behaviors will be displayed (Feist, 2009).  Freud developed the constructs of the Id, ego, and superego believing that the three work together to maintain a balance of emotion.  He believed the Id makes up the biggest portion of personality as it seeks out pleasure and immediate gratification despite potential consequences (Rana, 1997).  He further believed that the id developed a life and death instinct in all humans and that instinct provides all motivation (Rana, 1997).

Freud believed that Id controls the majority of personality because it seeks immediate gratification for selfish wants.  The ego serves as the regulator for personality and control center for the Id.  The superego is the judgment center and delivers internal feelings of punishment or gratification which determines self-worth.  Freud also placed emphasis on early childhood development because he believed that unresolved trauma in these early stages of life reflected in adult personality and behavior (Feist, 2009).  The trauma would cause a fixation in the individual that would hinder growth and advancement until the traumatic experience was recognized and dealt with (Feist, 2009).  Finally, Freud thought that individuals develop a defense mechanism known as repression.  Individuals who experienced a traumatic event would repress the memory deep in the unconscious mind as an avoidance effort. However, unless the repressed memory is brought to the conscious level and dealt with, Freud believed that an individual would not successfully transition to the next phase of life (Rana, 1997).

Humanism versus Psychodynamics

The humanistic approach and psychodynamic approach are notably the two most contradicting theories of personality psychology.  Humanism set out to disprove the psychodynamic approach as it evolved from the complete opposite beliefs of the psychodynamic approach.  Humanism took the optimistic approach that human nature is fundamentally good, and individuals are born as such.  It held the belief that humans can grow and maximize full potential over the lifespan through the choices made by their free will.  Humanism perceives societal as a destructive force that carries the potential to destroy the good in people as a society is highly influential over individuals as they strive to fit in (Feist, 2009).  On the other hand, the psychodynamic approach claimed individuals are born as evil, selfish beings who operate on principles of pleasure.  Individuals seek personal satisfaction even if means harm or pain to another individual.  Freud believed that moral values are instilled by society as the ego and superego develop.  He also believed that environmental and social interaction introduced the belief system which generates the moral code of the ego and superego.  Successful development mandates successful coping in the world. (Feist, 2009).

Humanism took the approach that personality took a lifetime to develop as individual’s progress and regress through the levels of the hierarchal needs developed by Maslow.  Maslow believed that reaching self-actualization is a difficult task accomplished by very few individuals (McLeod, 2007).  Freud’s psychodynamic approach found that an individual develops his or her personality in early childhood.  However, he also believed that any tragic events would interfere with the development of personality until the trauma is resolved.

The humanistic approach believed that motivation did not derive from incentive and rewards at the conscious level.  Maslow believed that humans had an internal desire to achieve personal satisfaction within themselves which causes motivation to activate within an individual.  He believed that physiological needs were necessary needs and the motivational factors developed as the individual attempts to achieve the basic necessary survival skills (Feist, 2009).  Freud believed the opposite.  He believed that motivation derived from selfish wants and obtaining gratification is the motivation (Ranan, 1997).  Obtaining gratification is the individual’s goal by any means possible, and little care is given to those who get hurt in the process.  Psychodynamists also believe that sex drive is a major motivational factor for humans.  Aggression and manifests itself in sex drive.  Today sex is a major motivator in media, entertainment, and personal satisfaction (Rana, 2015).

Similarities

Although there are so many differences between the two approaches, it is important to know that both approaches do have broad similarities allowing for further research to be conducted.  Both theories iterate the importance to view personality as an individualistic phenomenon of development (Feist, 2009).  The primary goal is to find the individual differences among people.  Both also approaches point out the importance of proper early development and the means it uses to prepare individuals for adulthood.  There is an agreement that development manifests at different stages and all stages must be completed in order for personality to completely develop and allow for individuality among societies (Rana, 1997).  As Freud failed to research the good in people, Maslow failed to research the bad in people which leaves both approaches unfinished and partially biased (McLeod, 2007).  Critics claim both approaches to be too philosophical with little objectivity.  The philosophical approach does not allow the research to be verified or falsifiable rendering both approaches as having a lack of scientific evidence.

Conclusion

Personality has its roots in philosophical ideas that psychologists could not resist.  Psychologists have dove deep into the human mind to learn what makes a human behave how they do and why humans behave how they do.  There are many theories and ideas of psychic bearings, and unconscious reciprocities, mixed with the intertwining of external factors to explain the possibilities of personality.  Unfortunately, psychologists have yet to declare a definitive definition.  The theories and ideas have opened infinite doors and guidelines for future understanding. 

References:

Feist, J.  & Feist, G.  J.  (2009).  Theories of personality (7th ed.).  New York, NY:  McGraw Hill.

McLeod, S. A. (2007). Humanism. Retrieved from http://www.simplypsychology.org/humanistic.html

McLeod, S. A. (2007). Maslow’s Hierarchy of Needs. Retrieved from http://www.simplypsychology.org/maslow.html

Rana, H. (1997). Muskingum. Retrieved from http://www.muskingum.edu/~psych/psycweb/history/freud.htm

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