Monthly Archives: February 2013

 

 

The National Institute on Drug Abuse  (NIDA) has a lot of resources for students and clinicians wanting to learn more about alcohol and drug abuse. Following our recent intern seminar on assessment of alcohol and drug use, our students requested a resource to help them recognize the names and street names of commonly abused drugs.

 

NIDA has just such a resource, in their Commonly Abused Drugs Chart and their Prescription Drug Abuse Chart. They also offer a very helpful Health Effects Chart.

 

Check these resources out. They have both street drugs of abuse and most common prescription drugs of abuse. The charts list street names, ways to use, and whether or not the drug is scheduled.

 

 

 

Nora S. Frank, BA CADC, CSC

 

 

 

In case you need a little something to tip your mood scale towards the side of happiness today, read on! The Facial Feedback Hypothesis suggests that you may have the ability to give yourself a little boost in mood–and it would only take a moment out of your busy day.  Robert Zajonc, Ph.D., former professor, Director of the Institute for Social Research, and Director for the Research Center of Group Dynamics at University of Michigan and Professor Emeritus of Psychology at Stanford University, believed that people could manipulate mood through a change in facial expression. Simply put: when we smile we become happier and when we frown we become sadder.

 

Dr. Zajonc explained that smiling causes facial muscles to stretch and tighten leading to a decrease in blood flow to the internal carotid artery, which is the route taken by much of the blood traveling to the brain.  The idea is that as blood flow decreases, so does brain temperature, which is believed to bring about more positive mood.  In contrast, as the muscles involved in frowning are tightened, the blood flow to the brain increases, increasing the temperature and, therefore, spurring a more negative mood.

 

Zajonc, R. B., Murphy, S. T. & Inglehart, M. (1989). Feeling and facial efference: Implications for the vascular theory of emotion Psychological Review, 96(3), 395-416.

 

Cassandra A. Sturycz, B.A.
Psychology Practicum Student

 

 

David J. Wright, MA., MSW
WKPIC Doctoral Intern

 

Schizophrenia causes pain, enormous suffering, and significant physical and emotional distress to the individual, but also to the primary caretakers. Recent headline news has focused on emotional stories that involved mental illness and psychosis. These stories are tangible, and the consequences of untreated mental illness continue to hurt members of our society. Increased understanding of this devastating disorder is essential to stopping this pain and damage.

 

In their article, the authors examine specific risk factors (i.e., familial liability and perinatal problems) that are often overlooked during young childhood and adolescent stages of development.  Family, twin, and adoption studies strongly suggest that genetic transmission accounts for most of the familial aggregation in schizophrenia. The risk of contracting the  disorder is about 10 times higher if a first-degree relative is ill, and decreases from close to more distant relatives. The authors review numerous studies about risk factors, which indicate that many people who develop schizophrenia are exposed to a variety of stressful perinatal events such as extreme maternal stress, maternal antenatal depression, prenatal exposure to influenza, living in an urban area, obstetrical complications, poor maternal nutrition, and famine, just to name a few.

 

The authors further present two models for the onset of psychosis; The Vulnerability Model and The Hybrid Model. The Vulnerability model addresses the diathesis-stress model, which explains individual behavior as a predisposition or vulnerability together with stress from life experiences. It can take the form of genetic, psychological, biological, or situational, environmental factors.  The Hybrid/interactive model is more or less an equilibrium model in which vulnerable individuals have possibilities to move in any direction between an asymptomatic and symptomatic state.

 

Salokangas & McGlashan (2008) take a proactive position about combating the acceleration of prodromal symptoms, which is potentially important for early intervention and comprehending the psychotic process. In clinical practice, a prodrome is an early symptom or set of symptoms that might indicate the start of psychotic-like experiences. The symptom profile of prodromes is extremely variable. The most frequent features include disturbances of attention or inability to concentrate, apathy or loss of drive, depression, sleep disturbances, anxiety, social withdrawal, suspiciousness, deterioration in school, work or other functioning, and anger coupled with irritability. Clearly, these are non-specific to schizophrenia and are very often seen, for example, in the early phases of depression. The prodrome to schizophrenia usually begins with additional nonspecific, neurotic-like symptoms, followed by more specific pre-psychotic symptoms, eventually leading to frank psychosis. The awareness of, early detection of, and aggressive treatment of these symptoms may prevent patients and families and entire communities from descending into the pandemonium of a completed psychotic process.

 

However, the key question remains: What interventions are available to patients at risk of psychosis? The authors address neuroleptic treatment, cognitive psychotherapy, and integrated treatment to define standards of care and contribute to best practices.

 

This article was useful to me at an internship level, in better understanding the risk factors associated with the evolution of schizophrenia, and the importance of early intervention into an evolving psychotic process.

 

References

 

Salokangas, R.K.R., & McGlashan ,T.H. (2008). Early detection and intervention of
psychosis. A review. Nord J Psychiatry 2008;62:92. Oslo. ISSN 0803-9488.

 

The Prodromal Phase of First-episode Psychosis: Past and Current Conceptualizations.  Retrieved from http://www.mentalhealth.com/mag1/scz/sb-prod.html.

 

 

 

 

So, like the internship classes of 1980-1982 (DSM-III) and 1994-1996 (DSM-IV), you’re the “tweeners.” You’re one of those unfortunate few students finishing school and hitting the licensing exam just as we’re switching to a new diagnostic manual. This time around, the madness is heightened by the fact that many, many settings have yet to determine if they will embrace DSM-V, or shift operations to ICD-10/11. Most will be taking full advantage of the two-year grace period before changing systems. Because of this, you face the very real possibility that you’ll train under one system, but have to tackle taking an Examination for the Professional Practice in Psychology (EPPP)  that focuses on a radically different diagnostic framework.

 

Stop screaming.

 

It’s do-able.

 

 

And here’s how, in two or three easy steps. Okay, maybe not easy, but not impossible, either!

 

First, remember how smart you are. You didn’t go to graduate school and finish all that work because you have difficulty learning new information. Remember those first few classes? You knew *nothing*, and now look how far you’ve come. Studying for the licensing exam, no matter which diagnostic system you use, is no different than all those exams and papers you’ve already conquered. Scarier, sure. But really, no different. You’ve got this.

 

Second, for those of you on internship right now, or who already have your Master’s Degree, you can take the examination before you finish internship, or just as you do. If you get in before the July 31, 2014 change date, you’ll miss all of the insanity and answer questions based on the DSM-IV-TR only. Problem solved. If you can pull this off before March, 2014, you’ll also save money, as the cost of the EPPP is going up, too. WKPIC has encouraged our current interns to consider this option, and we’re willing to assist with study time and quizzing as needed. Also, Dr. Kuszak just took the test on October 1, so she knows–she really, really knows–the angst involved and the preparation needed. She feels your pain! (She did great, by the way, YAY DR. K!!).

 

Finally, if taking the exam before the change date is not an option for you, we suggest that you quickly secure a copy of the DSM-V, or if you’re a WKPIC intern, use the student copy available in the state hospital intern office. Every time you render a diagnosis in DSM-IV-TR or ICD-10/11, take the extra 5-10 minutes to look up and write down the terminology used by the DSM-V as well. Discuss points of confusion with your supervisors. Trust us, we’ll be learning, too. These extra minutes could pay huge dividends for you, come examination time. Consider attending a continuing education seminar related to DSM-V, or viewing one by webinar as well. Your sites may have materials like this already available (we do, on our state hospital intranet), so be sure to ask about this possibility.

 

Alicia Taylor, Psy.D., WKPIC Internship Director
Susan Vaught, Ph.D., WKPIC Training Director

 

 

 

Keep calm and carry on. . .

 

Relaxation skills are important for all clinicians and clients. A great resource for guided relaxation exercises is Meditation Oasis. Mary and Richard Maddux have created a great online resource at the Meditation Oasis. On the site, you can find can find dozens of audio files, as well as “how to” guides for different types of relaxation and meditation. This resource is free and the audio files are available on the website and as an iTunes podcast.

 

 

 

 

Danielle M. McNeill, M.S., M.A.
WKPIC Doctoral Intern