Case Incident 2: Lonely Employees

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Case Incident 2: Lonely Employees

Case Incident 2: Lonely Employees

Review the “Lonely Employees” Case Incident 2 on page 660 and respond with answers to the questions using your critical thinking and moral reasoning skills.

Case Incident 2: Lonely Employees

“Teachers don’t have a chance to talk to each other very much … it is an amazingly lonely profession,” John Ewing, president of Math for America, notes. Math for America is a nonprofit that aims to improve science, technology, engineering, and math (STEM) teaching excellence by rewarding those who excel at it already. Another standout element of its model is to combat loneliness by forging a community of mutual social support. By providing opportunities to network and form relationships with other teachers, and thus create a community of STEM educator professionals, Ewing hopes that “it keeps people who are in their eighth or ninth year … teaching.” Steven Miranda, the managing director of Cornell University’s Center for Advanced Human Resource Studies, suggests that loneliness may not just lead to turnover but also to poor motivation and organizational citizenship behavior (OCB). “I would bet my bottom dollar that people who are lonely and disengaged at work deliver far less discretionary effort than people who have a support system or a go-to person.”

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Research corroborates Miranda’s and Ewing’s observations: A study of over 500 Macanese school teachers suggests that workplace loneliness has an impact on job performance and OCB. The reason is that lonely employees do not have high-quality exchanges with their leaders and coworkers. Additional research suggests that loneliness not only negatively affects performance but also can lead to critical health problems, cognitive decline, and even early death—some are even calling it a public health epidemic.

Loneliness can be cumbersome for leadership as well. As Jim Hertlein, managing director of Boyden (an executive search firm), says, “A CEO’s role is probably the loneliest in the business … they’re expected to be always on their game. They’re not allowed to have a bad day.” However, this might be contingent on the degree of power that leaders have. Studies have shown that having more power actually decreases one’s loneliness. This might be because those in power often feel the need to belong a lot less and thus feel less lonely.

Overall, combating loneliness in the workplace can begin with you: By reaching out to colleagues and building bridges, you can create friendships and help alleviate the strain of being lonely. Managers and supervisors may also be able to help by structuring work and cultivating an atmosphere where coworkers can become interpersonally engaged and connected to one another.

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Questions

18-17. How might a volatile work environment in which changes occur constantly affect loneliness? How might a stable work environment where the status quo does not change affect loneliness?

18-18. Who do you think loneliness tends to be more of a problem for, employees or their supervisors (or managers or executives)? Explain.

18-19. What role does society play in crafting a global corporate culture of loneliness? Explain.

Diversity Awareness

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Diversity Awareness

Diversity Awareness

Discussion 1

In BEHS 220 (Diversity Awareness), you may have learned about the many ways of “being human.” The United States is a culturally diverse country, and while we continue today to grapple with tensions related to race, ethnicity, sexuality, gender, religion, and age, the very fact that we can have public debates about matters related to diversity is some measure of social progress. Across the globe, there are many instances where groups of people continue to be oppressed along dimensions of diversity.

For this discussion, you will review some terminology related to diversity and cross-cultural relations, and then you will demonstrate your understanding of these terms as they relate to a practice that most in the United States would agree is unpalatable.

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Review this week’s Learning Resources.

Here are some terms that are often included in discussions about diversity:

• Cultural pluralism is the recognition that society consists of many diverse groups that have unique cultural identities and practices that continue to exist within a larger, more dominant society.

• Multicultural societies consist of many diverse groups, none of which are socially dominant.

• Cultural relativism is the idea that an individual’s behavior and beliefs can only be understood in terms of that individual’s culture.

For this discussion, respond to the following questions:

• What is the cultural basis for female genital mutilation (FGM)?

• What would a “cultural relativist” say regarding the acceptability of FGM?

• How can we reconcile cultural relativism with the need for human rights?

• What role does globalization play in changing cultural practices?

When writing your posts, it is very important that you focus not just on summary but also on analysis. These posts are how I determine your mastery of the material and your critical thinking. Remember:

• Make sure you start your initial post as a New Thread in the LEO Discussion board, or I might not find it when I grade.

• Your first paragraph needs to be an introduction to your post.

• Your final paragraph should be a conclusion which pulls your ideas together.

• Your middle paragraphs should discuss your arguments.

• All posts need to be written in APA style and cite resources. You are encouraged to draw on resources from your courses across your entire major. There is not a lot of new information learned in this course, as I want to see you bringing together all of what you have learned at this college.

• Please check your post against the Guide for Good Writing before you submit it, as points will be deducted if you make those common writing errors. (This document is located in the Writing Resources module.)

Diversity Awareness

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Discussion 2

This week, we continue our look at some important contemporary social problems in order to get us in the habit of thinking from an interdisciplinary social science perspective.

Trayvon Martin. Ferguson. Freddie Gray. “I can’t breathe.” These names and phrases have taken on special significance in recent years as iconic touchpoints highlighting systemic racial injustice in the United States. These touchpoints have given rise to a modern wave of Black activism that is reminiscent of the Civil Rights movement of the mid 1900’s. Leading the way is the “Black Lives Matter” (BLM) movement which emerged in response to the death of Trayvon Martin in 2012 and continues to have a voice in matters of inequality that impact Black Americans.

The “Black Lives Matter” movement has sparked a fervid national conversation on the state of race relations that is multilayered and complex. At its core, the movement raises concerns about the treatment of Black Americans across many social institutions (e.g. law enforcement, criminal justice, employment, education, etc.), but other debates have emerged from the movement. Should the concerns of Black Americans be considered separately or as part of a larger conversation that includes all races? Why is the phrase “All Lives Matter” antithetical to the goals of the BLM movement? How does the BLM movement address black-on-black violence? How do minorities reconcile oppression with patriotism?

As social scientists, you may be called upon to provide an opinion on difficult social topics like race and racism. By now you know that an informed opinion should be measured, based on evidence, and take into account multiple perspectives. For this topic, it’s important to understand the historical underpinnings of Black activism that have led to the “Black Lives Matter” movement of today.

Explore this week’s Learning Resources as well as the following pages from the BlackLivesMatter.com site:

• http://blacklivesmatter.com/about/

• http://blacklivesmatter.com/herstory/

• https://blacklivesmatter.com/blm-demands/

After reviewing these resources (and others that you may find), respond to the following questions:

1) Identify some pivotal moments or issues from before the year 2000 that have shaped the civil rights movement and set the stage for the “Black Lives Matter” movement.

2) In your own words, what is the “Black Lives Matter” Movement and what is its primary mission?

3) How have people from diverse backgrounds reacted to the “Black Lives Matter” Movement? Provide some examples from the news or the Web to support your response. Remember to cite your sources.

4) How might social scientists from different disciplines talk about these issues? For example, what questions would a psychologist ask compared to an anthropologist? What issues would be the focus of a sociologist? How might a gerontologist frame this problem (think about what older people may have witnessed or experienced regarding race relations)? What other social scientists might be interested in this issue?

5) What are some potential controversies inherent in this issue? Think about why this social problem might be difficult to solve. Are there gaps in our knowledge? Lack of resources? Opposing political views? Think broadly and from an interdisciplinary perspective in order to respond to this question.

6) Where does the solution lie? Are there policies that need to be changed or enacted to resolve the issue? Are there programs or services that might help? What agencies or industries are best equipped to help?

When writing your posts, it is very important that you focus not just on summary but also on analysis. These posts are how I determine your mastery of the material and your critical thinking.

Women’s Rights

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Women's Rights

Women’s Rights

Informative, good blogging is more than just random thoughts on the screen. They convey a coherent, organized theme or set of ideas. For people to take your blog seriously (when blogging about a serious topic), they need to have thought, good analysis, and a point that conveys part of the story you are trying to create. So, your blog needs to have some thought to it.

You should feel free to find other sources about blogging on the internet. The more you know, the more effective you can make your message.

What will you and your peers be looking for when we read your blog? Here are some tips for making good blog entries and pages.

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On the Writing

  • Create a resource for people — your blog is not a newspaper, it’s a reflection of what you have as your passion for the subject. While you might reference news articles as a basis of your ideas, be informative and convey that information. You are writing for an interested audience.
  • Don’t under or over-write — keep your entries between 300 – 1000 words.
  • When writing, have a point! Don’t open your word editor and just barf out words. Have a point and elaborate on that point
  • Think about why you are blogging and what information you are going to convey to your target audience.
  • Have conviction! Pick a side, make an argument. If you turn out to be wrong, admit it, and move along. Think about commentary that is left and play off of ideas.
  • Keep the writing simple and short; no need to have multiple compound sentences linked by a couple of hundred semicolons. Keep in mind, this is a different kind of writing style than you will be doing in other sections of the course.
  • Go back and read what you wrote on the blog entry. Think about these things:
    • Catchy title?
    • Keywords (not so critical for the class, but it is important in developing blogging skills)
    • Links work?
    • Did you cite your sources appropriately and link to them?
    • Does your entry have credibility? Ideas and thoughts supported with something are best. Your blog shouldn’t always be a personal journal but an informative journal.
    • Do not copy or plagiarize other blogs or sites. With appropriate links and citations, they can be the basis for a good blog entry, but you need to give credit where credit is due. Likewise, add something to it. A blog entry shouldn’t be “Umm, here’s something cool” with a link.
    • Feel free to spread your words of wisdom on social media — Facebook, Twitter, Instagram, Pinterest, Reddit… and with friends; wherever you want your audience to be or where you think they are.

Expect criticism! It’s a good thing if it’s constructive and gets you thinking about it.

Find inspiration through current events, new studies

Just read the blog part that I attached for you I need a reference in the end okay

and please no copy and paste please the teach is really hard okay buddy

 

Vulnerable Populations

Vulnerable Populations, get homework help at Top Grade Essay Writings.

Vulnerable Populations

Vulnerable Populations

Read the following attached articles:

A Profile in Population Health Management: The Sandra Eskenazi Center for Brain Care Innovation: This Care Model Emphasizes Social, Behavioral, and Environmental Determinants of Health When Treating Dementia

Accounting for Accountable Care: Value-Based Population Health Management

How Executives’ Expectations and Experiences Shape Population Health Management Strategies

Watch the following video:

What Is Population Health? (https://www.youtube.com/watch?v=AtBYryLAveE)

After the passage of the Patient Protection and Affordable Care Act of 2010, health care organizations have been faced with significant challenges in providing quality care to all Americans. HealthyPeople.gov  (https://health.gov/healthypeople) also encourages health care organizations to focus on the relevance of social determinants and health status.

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Take on the role of the administrator of a community hospital in Atlanta, Georgia. You would like to implement a strategic plan to improve the health status of your community. Select a vulnerable population in Atlanta, Georgia affected by a disease or condition. Examples include aging, COVID-19, diabetes, Ebola, heart disease, opioid epidemics, Zikavirus, etc. In three to five pages, detail your strategic plan to address the following:

Healthcare Workforce Diversity & Healthcare Accessibility

Healthcare Workforce Diversity & Healthcare Accessibility, get homework help at Top Grade Essay Writings.

Healthcare Workforce Diversity & Healthcare Accessibility

Healthcare Workforce Diversity & Healthcare Accessibility

Prior to beginning work on this discussion forum, read the attached or watch the following:

Watch the following two videos:

Why Is Healthcare Workforce Diversity Important? (https://www.youtube.com/watch?v=08pCbH629sY)

Inclusion is a Culture of Value and Belonging (https://www.youtube.com/watch?v=UvRWkWZgnRY)

Take on the role of manager of a Federally Qualified Health Center (https://www.hrsa.gov/opa/eligibility-and-registration/health-centers/fqhc)  that provides primary care services to a multi-ethnic, multi-lingual urban community. Many of the patients live below the poverty line. Health care providers in your center see a high volume of patients with challenging medical and psychosocial issues. Because of the high volume of patients, acutely ill patients often wait for two to three days to see a health care provider. Many patients walk in without appointments.

On the other hand, about 35% of patients fail to show up for appointments on a given day. As you investigate the problem, it is becoming increasingly clear to you that the better-insured and English-speaking patients may receive better access. They are more likely to get a timely appointment, keep the appointment, and show up for their appointments because of better communication. You are interested in promoting more equitable access to health care. You understand the importance of providing culturally sensitive, patient-centered care and a diverse clinic environment to make patients feel more welcome.

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In 500 to 600 words, address the following

  • Propose at least three strategies to solve the problem in your health center.
  • Support your response with a minimum of two scholarly sources published in the last five years. All sources must be cited using proper APA Style.

Nursing Scenario #2

Nursing Scenario #2, get online writing help at Top Grade Essay Writings.

Nursing Scenario #2

Nursing Scenario #2

Reply to the following discussion

Scenario 2: 33-old female of Hispanic descent Case Study

A. To assess this 33-year-old Hispanic woman, I would employ Bowen’s family systems theory and Leininger’s transcultural theory. The Bowen family systems theory represents the best approach. Her obesity, hypertension, and depression can significantly impact how other family members feel, think, and conduct themselves. Bowen’s family systems
theory considers the family as an emotional unit, and the numerous interconnections within the family are described by systems thinking (Couto et al., 2018). By their very nature, families are deeply emotionally linked, and one member’s sorrow can severely impact these connections and relationships. The patient and their family members may be influenced by their treatment, so the entire family system should be considered.

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Different cultures have distinct ways of understanding, providing healthcare, knowing, and anticipating receiving care (Marilyn et al., 2019). To foster compliance, well-being, and healing, patient care should provide culturally tailored therapy and manage the patient and family as a system. The transcultural theory holds that empathy, compassion, and culture are strongly linked.
B. One should start by obtaining an experienced interpreter. Because the patient is Hispanic, a competent translator will be of the highest help to ensure that the client knows and understands the care offered. I could approach this patient courteously, attentively, and curiously, and I would query about the patient’s social identity, culture, and intentions for their care.
As the assessment advances, I would ask them about their history of mental illnesses while making careful and accurate notes of their disease symptoms and maintaining an eye out for mood changes. I would start with open-ended inquiries before moving on to more focused investigations. In learning from the patient and assisting the patient in receiving better care, I must approach the client neutrally and clarify why I want to know detailed information, such as any ideas of self-harm.

 

Leadership And Conflict Management

Leadership And Conflict Management, get homework help at Top Grade Essay Writings.

Leadership And Conflict Management

Leadership And Conflict Management

Assignment Content

  1. In Wk 2, you proposed how you would build your own team. Now, your newly formed team is starting to work on its first real project that needs to have strong collaboration and a quick turnaround. However, your team has encountered the following challenges:

 

Nurse Leader As A Knowledge Worker

Nurse Leader As A Knowledge Worker, get assignment help online at Top Grade Essay Writings.

Nurse Leader As A Knowledge Worker

Nurse Leader As A Knowledge Worker

NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology

Analyze how data collection and access can be used to derive knowledge in a healthcare setting

Analyze the role of the nurse leader in using clinical reasoning and judgement in the formation of knowledge

Explain the role of the nurse as a knowledge worker 

Explain concepts of nursing informatics

Create infographics related to nursing informatics and the role of the nurse as a knowledge worker

Required Readings

McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.

Chapter 1, “Nursing Science and the Foundation of Knowledge” (pp. 7–17)

Chapter 2, “Introduction to Information, Information Science, and Information Systems” (pp. 21–32)

Chapter 3, “Computer Science and the Foundation of Knowledge Model” (pp. 35–64)

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).

Required Media

Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.

Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health [Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8Hpfo

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Discussion: The Application of Data to Problem-Solving

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner€™s and the discipline€™s body of knowledge.

Assignment: The Nurse Leader as Knowledge Worker

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?

Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.

In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker.

Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.

To Prepare:

Review the concepts of informatics as presented in the Resources.

Reflect on the role of a nurse leader as a knowledge worker.

Consider how knowledge may be informed by data that is collected/accessed.

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The Assignment:

Explain the concept of a knowledge worker.

Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.

Include one slide that visually represents the role of a nurse leader as knowledge worker.

Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data.

My discussion that is going to need to be incorporated

with the theme of this PowerPoint is going to be infection control nurses and healthcare associated infections.

Homework on psychotic disorders

Homework on psychotic disorders, get assignment help at Top Grade Essay Writings.

Homework on psychotic disorders

 

Homework on psychotic disorders

  • Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing psychotic disorders. Consider whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Think about alternative diagnoses for psychosis-related symptoms.
  • Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
  • By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
  • Consider what history would be necessary to collect from this patient.
  • Consider what interview questions you would need to ask this patient.
  • Identify at least three possible differential diagnoses for the patient.

Homework on psychotic disorders

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

Cognitive Behavior Therapy (CBT)

Cognitive Behavior Therapy (CBT), get online writing help at Top Grade Essay Writings.

Cognitive Behavior Therapy (CBT)

Cognitive Behavior Therapy (CBT)

Student 1: Judy

What medications are considered first-line best practices for treating anxiety? How long can they expect these medications to take full effect? Alternative to use?

Selective serotonin reuptake inhibitors (SSRIs) are recommended as a first-line treatment for anxiety disorders (Bandelow et al., 2017). They increase serotonin levels by blocking the serotonin transporter (SERT) which helps to reduce anxiety (Stahl & Muntner, 2021). These drugs can be used long-term due to better tolerability, less sedation, and less chance of abuse or withdrawal (Bandelow et al., 2017). A study that was conducted by Jakubovski et al (2018), also reported that serotonin-norepinephrine reuptake inhibitors (SNRIs) are also the first-line pharmacological treatment for anxiety disorders, but higher doses of these medications are not needed to relieve anxiety. Therefore, the pharmacotherapeutic treatment is somewhat a matter of professional expertise and what the provider is comfortable with prescribing.

What therapy would be indicated for someone with anxiety?

Cognitive behavior therapy (CBT) can be indicated for someone with anxiety. It can be used to examine negative thoughts that contribute to anxiety symptoms and replace those thoughts with more positive realistic thoughts. This type of therapy approach is to help clients identify irrational thoughts and help them analyze their negative beliefs. Furthermore, the use of an SSRI with CBT can reduce the activity in the amygdala and insula which is responsible for pain and emotional perception, and addictive behaviors (Gorka et al., 2019).

What do you need to assess before prescribing a benzodiazepine? What special considerations should be given and discussed with the patient?

Benzodiazepines may be used in the management of diseases such as insomnia or anxiety. However, the use of benzodiazepines can result in respiratory depression due to its effects on the central nervous system hence patients should be educated on its use and contraindications. Benzodiazepines are recommended for short-term pharmacotherapeutic treatment use due to the significant risk of dependence. Long-term benzodiazepines should be avoided if possible due to the risk of dependence, possible abuse, and cognitive decline (Stahl, 2017). Moreover, patients should be tapered off long-term use if they can tolerate the discontinuation without severe withdrawal. According to Takaesu et al (2019), patients taking benzodiazepines are at increased risk of cognitive function decline, falls, as well as dependence, and tolerance. That being said, benzodiazepines should not be considered first-line due to their high potential for abuse.

Last Name: I-N

Body Dysmorphic Disorder (F45.22)

Cognitive Behavior Therapy (CBT)

How would you define the disorder?

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) (2013), defines body dysmorphic disorder (BDD) as a preoccupation with one or more flaws in physical appearance that others do not see that causes social anxiety and avoidance. Individuals who have BDD excessively look at themselves in the mirror, and they are always grooming themselves. These types of behaviors cause a significant amount of distress which affects one’s everyday functioning. The person with BDD cannot control these behaviors and therefore has a high level of anxiety. They are always concerned about their appearance and try to compare themselves with others. Their preoccupation is not related to their weight or body fat therefore they do not have an eating disorder (American Psychiatric Association, 2013). Some individuals with this disorder have beliefs that their body is built too thin with insufficient muscles. Additionally, individuals have compulsions and obsessions that are mainly focused on their physical appearance, and they are usually time-consuming as well as difficult to control (American Psychiatric Association, 2013). According to Nicewicz and Boutrouille (2021), BDD was first recognized as an atypical somatoform disorder.

What signs/symptoms would one see in the patient that demonstrate the disorder?

The signs and symptoms that one would see that demonstrate body dysmorphic disorder are individuals engaging in repetitive behaviors, such as excessive mirror checking, compulsive skin picking, camouflaging, participating in excessive grooming, excessive weightlifting, or pervasive mental acts that involve them comparing themselves to other people (Field, 2018). These perceived physical flaws most commonly occur on the skin, hair, or nose, but any body part can be involved. An individual is hyper-focused on his/her appearance which makes them believe that they are ugly and unattractive. They are usually concerned about their eyes, teeth, lips, breasts, stomach, genitals, and legs among others (American Psychiatric Association, 2013). They compare themselves with other people, they think other people are taking note of their negative appearance and they might repeatedly apply makeup to try to cover flaws. Some individuals end up seeking medical procedures, excessively tanning their skin, and changing their clothes excessively (American Psychiatric Association, 2013). They also tend to seek reassurance from others about how they look and sometimes avoid social situations due to fear of being judged or maybe people will notice their imperfections.

Cognitive Behavior Therapy (CBT)

What are the main DSM-5 criteria for this disorder?

According to the DSM 5, body dysmorphic disorder is classified under obsessive-compulsive and related disorders. An individual exhibits the four of the following features to meet the diagnostic criteria:

Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable by others or others slightly notices them (American Psychiatric Association, 2013, p.242).

The person performs repetitive behaviors such as checking mirrors, excessive grooming, skin picking, reassurance-seeking, or mental acts that are concerning to their appearance (American Psychiatric Association, 2013, p.242).

The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. (American Psychiatric Association, 2013, p.242).

The appearance preoccupation is not explained by concerns with body fat or weight that one meets the criteria for an eating disorder. (American Psychiatric Association, 2013, p.242).

What is the top 3 differential diagnosis for this disorder from the DSM-5?

The three top differential diagnoses from the DSM-5 include Obsessive-compulsive disorder whereby there are preoccupations and repetitive behaviors. However, in BDD they are more focused on their appearance hence the skin picking to improve how they look. The second is an eating disorder this can be comorbid. Thirdly is anxiety disorders which are common in body dysmorphic disorder. However, in BDD the anxiety is appearance-related and not social or avoidance (American Psychiatric Association, 2013).

Cognitive Behavior Therapy (CBT)

What medications would you use? Why? Black box warnings?

Before prescribing any medications, I would first obtain consent for treatment. It is important to explain to the patient all the risks versus benefits of the medication. The medication class that is preferred for patients with BDD is selective serotonin reuptake inhibitors (SSRIs). According to Nicewicz and Boutrouille (2021), Fluoxetine is the recommended drug to treat BDD. The dosage will be 20mg daily as it is important to start low and see how the patient might tolerate the drug. The goal will be to reduce the symptoms. The onset of action is usually delayed 2-4 weeks and if it is not working within 6-8 but the patient is tolerating the drug then it should be increased. The side effects that need to be discussed with the patient include nausea, diarrhea, headache, drowsiness or activation, sexual dysfunction, or desire. Serious adverse effects include suicidal thoughts and/or behaviors, mania, and seizures (Stahl, 2021). While waiting on the therapeutic effects to take effect, the patient can also be started on a small dose of benzodiazepine short-term to give some relief to the distressing symptoms.

What type of therapy would you recommend for this patient?

The types of therapy that have shown to be beneficial for patients with BDD include cognitive-behavioral therapy (CBT) and metacognitive therapy (Phillipou et al., 2016). CBT is the recommended first line of treatment for BDD. These types of therapy will help the patient to work on his/her self-confidence. Also, help in identifying the behaviors and triggers that cause these feelings.

Cognitive Behavior Therapy (CBT)

What do you see as the possible outcomes for this patient?

Clinicians need to communicate realistic expectations to patients who are diagnosed with BDD at the beginning of treatment and explain that their disorder might not be cured but the goal is a reduction of symptoms. The outcome for the patient would be to continue taking fluoxetine until the symptoms of BDD have resolved or have been significantly reduced. Also, for the patient to participate in cognitive behavioral therapy to manage negative thoughts and modify behaviors.

What are the 5 components of a suicide risk assessment that the patient needs to be asked?

The five components of the suicide risk assessment that the patient needs to be asked are do you have current thoughts of killing yourself, what are your intentions, do you have a plan, have you ever tried to kill yourself in the past, what is keeping you alive, or what might decrease the chances of you trying to kill yourself as suicidality is high within individuals with body dysmorphic disorder. Furthermore, 80% of individuals with body dysmorphic disorder think about suicide while approximately 26% of those individuals have attempted suicide (Koenig et al., 2021).

In addition to the suicide risk assessment questions, the clinical can conduct a physical assessment of an individual who has body dysmorphic disorder, he or she might notice some skin lesions secondary to skin picking. Most patients with BDD have a history of self-inflicted injuries. Although clients might not want to share with the clinicians about their disorders, it is important to ask them questions about any cosmetic procedures, or surgical interventions. Also find out how they feel about their appearance, how much time they spend worrying about their appearance, and ask whether their condition affects their quality of life. Find out if the patient has other dermatologic issues. Find out the onset and duration of symptoms. Ask if the patient has mental health history in his or her family or if he/she is experiencing any significant life changes or stressors. It is also imperative for the clinician to assess and rule out disorders and other comorbidities like social anxiety disorder and obsessive-compulsive disorder (American Psychiatric Association 2013).

Student 2: Klaus

What medications are considered first line best practice for treating anxiety? How long can they expect these medications to take full effect? Alternative to use?

To treat social anxiety disorder, health care providers may prescribe medications. This disorder can be effectively treated with a variety of medications, including selected serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are antidepressants (SNRIs); this class of medications may take several weeks to reach their effect usually four to six weeks; alternatively, benzodiazepines can also be utilized and these usually take a shorter time to take effect but long term use is contradicted as it can be addictive (Mayo Foundation for medical Education and Research, 2021).

What therapy would be indicated for someone with anxiety?

Most patients with social anxiety disorder benefit from psychotherapy. In therapy, you will learn how to recognize and modify negative beliefs about yourself as well as build skills to help you achieve social confidence; CBT (cognitive behavioral therapy) is the most successful type of psychotherapy for anxiety, and it can be used either individually or in groups (Mayo Foundation for medical Education and Research, 2021).

What do you need to assess before prescribing a benzodiazepine? What special considerations should be given and discussed with the patient?

Examine the patient for signs of addiction and abuse. Benzodiazepines should not be used by patients who have a history of substance abuse, particularly prescriiption drug abuse; If the patient has other risk factors, use cautious, such as: a background of chronic pain, a history of substance abuse and behavioral addictions in the family (Mayo Foundation for medical Education and Research, 2021).

Cognitive Behavior Therapy (CBT)

Social Anxiety Disorder

How would you define the disorder?

In situations where they may be inspected, assessed, or judged by others, such as speaking in public, meeting new people, answering a question in class, or having to chat to a cashier in a store, a person with social anxiety disorder experiences anxiety or terror; commonplace activities such as eating or drinking in front of people or using a public lavatory, might generate anxiety or dread of being embarrassed, judged, or rejected (Mayo Foundation for medical Education and Research, 2021).

What signs/symptoms would one see in the patient that demonstrate the disorder?

Unlike ordinary uneasiness, social anxiety disorder include fear, anxiety, and avoidance that interfere with relationships, daily routines, job, school, or other activities (Mayo Foundation for medical Education and Research, 2021).

What are the main DSM-5 criteria for this disorder?

Several criteria are involved when diagnosing someone with social anxiety disorder (DSM-5 definition of social anxiety disorder, n.d).

persistent anxiety of being exposed to unfamiliar people or being scrutinized by others in one or more social or performance circumstances. The person is afraid that he or she may do something embarrassing and humiliating (or show anxiety symptoms).

Being exposed to the feared situation nearly always causes worry, which can manifest as a situationally bound or predisposed Panic Attack.

The individual recognizes that his or her fear is irrational or excessive.

Fearful circumstances are avoided or endured with a great deal of anxiety and distress.

The avoidance, nervous anticipation, or distress in the dreaded social or performance situation(s) severely interferes with the person’s usual routine, occupational (academic) functioning, social activities, or relationships, or the person feels distressed by having the phobia.

The fear, worry, or avoidance is long-term, usually lasting six months or more.

4.

What are the top 3 differential diagnosis for this disorder from the DSM-5?

panic disorder

agoraphobia

atypical depression

5.

What medications would you use? Why? Black box warnings?

Though there are a variety of drugs available, selective serotonin reuptake inhibitors (SSRIs) are frequently used to treat chronic social anxiety symptoms. Sertraline or paroxetine (Paxil) may be prescribed by your doctor (Zoloft); Venlafaxine (Effexor XR), a serotonin and norepinephrine reuptake inhibitor (SNRI), may also be used to treat social anxiety disorder (Mayo Foundation for medical Education and Research, 2021).

What type of therapy would you recommend for this patient?

Most patients with social anxiety disorder benefit from psychotherapy. In therapy, you will learn how to recognize and modify negative beliefs about yourself as well as build skills to help you achieve social confidence; CBT (cognitive behavioral therapy) is the most successful type of psychotherapy for anxiety, and it can be used either individually or in groups (Mayo Foundation for medical Education and Research, 2021).

What do you see as the possible outcomes for this patient?

Combination of an appropriate therapy and medications as last resort should be helpful to this patient to a high degree and go a long way in increasing the prognosis

What are the 5 components of a suicide risk assessment (From the PowerPoint/Kaltura in Week1) that the patient needs to be asked?

I’ll as if the patient has any plans of killing themselves

Ask what the plan is

Seek to know if they has any access to the plan

Seek to know their intention

Seek to find out what is keeping them from executing the plan so far