WKPIC says a hearty HELLO to Anissa Pugh, Crystal Henson, Michael Daniel, Katy Roth, and Georgetta Harris-Wyatt. We are happy–and fortunate–to have you! Looking forward to a great year. And I didn’t mean to put you all into a pizza-sugar-info-overload coma.
Susan Redmond-Vaught, Ph.D.
Director, WKPIC
Once again, the time has come to bid farewell to an intern class. Our 2016-2017 interns are officially loose in the world, to do all the good they can do–which I believe will be an amazing amount.
Congratulations, ladies. YOU DID IT!!
Dr. Vaught and the WKPIC Supervisors and Instructors
<Discussion is not an endorsement, for informational purposes only>
Project Daris is a free resource that came out of a heartbreaking tragedy. Project Daris was started by the parents of Daris Fent, a talented young man with a bright future who tragically lost his life to a heroin overdose. Daris was an accomplished guitarist, an excellent student, was well-liked among his peers, and after graduating high school he became a Marine. By all accounts, he was just a good young man with a goal of helping others. Sadly, he developed an addiction to prescription Oxycontin due to an injury sustained while in the military; he was able to hide his addiction for several years, until he had no other option but to ask for help. He attended rehab, and initially was successful in beating addiction. However, he relapsed in less than 30 days, and it was during the relapse that he overdosed.
It was from this tragedy that his parents set up Project Daris to help prevent what happened to Daris from happening to others. Consisting of a group of healthcare professionals that includes doctors, pharmacists, and nurses, Project Daris provides free substance abuse prevention education to grades K-12 in Kentucky with the goal of reaching children in all 120 counties. Project Daris provides age appropriate materials to all age groups, and where appropriate and permissible for grades 6-12, people in long term recovery are brought in to share their stories. The program can address a classroom or an entire school, and considering that 1 in 4 middle and high school students admit to having abused drugs, the earlier education is shared concerning the dangers of drug abuse and addiction the better. The program takes about an hour for a full presentation, is 100% free due to being privately funded by concerned healthcare professionals, and is a unique educational opportunity for students.
For further information, or to schedule a visit, please contact Dr Robert Goforth Pharm.D, RPh., at robert@projectdaris.com.
Teresa King
PMHC Intern
Suicide and suicidal ideation have recently been brought to the fore of the public consciousness by way of a popular teen show called “13 Reasons Why”. Although I view this show as an absolute trainwreck due to the nature of the subject matter and how it is portrayed by the producers of the show, it has opened up a bit of a dialogue by touching on a subject that is extremely sensitive, often misunderstood, and difficult to broach as a topic of conversation. While suicide is complicated and tragic, it is also often preventable when the signs that signal its impending occurrence are recognized and help is sought. Over 40,000 people die by suicide in the US each year, making it a serious public health concern as the 10th leading cause of death overall.
The signs of suicidal ideation aren’t difficult to recognize, as there is a particular list of behaviors that tend to be early warning signals that someone is contemplating the taking of their own life in a serious way. Someone who is contemplating seriously contemplating suicide may talk openly about feeling hopeless, having no reason to live, or wanting to die or kill themselves. They may confide that they are in unbearable emotional or physical pain, dealing with tremendous guilt or shame, or feeling trapped in a hopeless situation or circumstance with no solution or way out other than death. Many times they will even reveal that they are working on a plan or looking for a way to commit suicide. They may begin using alcohol or drugs as a coping mechanism, or increase the use of same if they are already users. People with suicidal ideations often talk of being a burden on others, such as loved ones, friends, or coworkers, and may act anxious/agitated while slowly withdrawing from friends and family. Noticeable changes in eating or sleeping habits, showing rage, talk of “seeking revenge”, or taking unnecessary risks that could be fatal, such as driving recklessly, are often indicators of suicidal ideation, and may or may not be accompanied by displays of extreme mood swings. Someone who is contemplating the taking of their own life may be talking or thinking about death constantly, and they may prepare for the final act by saying goodbye to family and friends, giving away important possessions, or by getting their affairs in order and making a will or some other legal document as to the final disposition of their estate. While these criteria may not necessarily be indicators of suicidal ideation in and of themselves singularly, you should seek help as soon as possible if these warning signs apply to you or someone you know plurally, especially if the behavior(s) are new or have recently increased in frequency.
There are several risk factors and indicators that may signal if someone is contemplating suicide, and it is important to realize that suicide is non-discriminatory. Anyone of any gender, age, or ethnicity can be a suicide risk. The behaviors associated with suicide are complex, with no single cause; many different contributing factors are present for someone who attempts to take their own life. However, those most at risk do tend to share certain risk factors for suicide:
Many people often have some of these risk factors, but do not attempt suicide or display suicidal ideations. This is because suicide is not considered to be a normal response to stress; thoughts or actions of a suicidal nature are a sign that someone is in extreme distress requiring immediate intervention and assistance. When suicidal ideations or actions are displayed by someone, it should not be ignored, or written off as a harmless bid for attention. Friends and family are usually the first to recognize the warning signs of suicide, and are usually in the best position to assist with helping someone who is at-risk find the specialized treatment that will be required to address the diagnosis and treatment of the mental health conditions that are the root of the problem.
The demographics of suicide with regard to race/ethnicity, age, and gender as related to risk are interesting. Women are more likely than men to attempt suicide, but men are more likely to actually be successful in the attempt due to a predilection for choosing deadlier methods such as firearms or suffocation, where women show a preference for suicide by poisoning. Women are most likely to attempt suicide between the ages of 45 and 64, while men peak at ages 75 and up. In younger people, suicide is the second leading cause of death in the 15 to 34 age range. Native American Indians, as well as Alaskan Natives, tend to have the highest rate of suicides among ethnic groups, just ahead of non-Hispanic whites, while African Americans trend toward the lowest rate of suicide, with Hispanics at the second lowest rate.
If you recognize the signs of suicidal ideation/contemplation and want to offer assistance, there are 5 steps you can take to assist someone who is at a suicidal level of distress. The first thing to do is to ask “Are you thinking of killing yourself?” A tough question, yes, but asking it hasn’t been shown to increase suicides or suicidal thoughts. Secondly, keep them safe by reducing or preventing their access to lethal items or places. This is an important aspect of suicide prevention, along with asking if they have a plan for their suicide and then removing or disabling the lethal means to complete their plan. The third step involves listening carefully to ascertain what the person is thinking and feeling. Talking about and acknowledging suicide may actually decrease suicidal thoughts and ideations. Next, assist them with reaching out and making a connection. The National Suicide Prevention Lifeline at 1-800-273-8255 (TALK), or a trusted family member, friend, or mental health professional can help make all the difference in assisting them with getting the help they so desperately need to overcome their crisis. Finally, stay in touch after the crisis. Studies have proven that someone following up with an at-risk individual after they’ve been discharged from care reduces their risk of recurrence.
The ability to get immediate help for someone who is contemplating suicide is critical; instant access to emergency numbers can mean the difference between saving a life and losing one. The non-emergency number to the local police department, the number of a trusted friend or relative, the Crisis Text Line at 741741, and the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) should be saved for quick retrieval in your cell phone, along with any other local emergency numbers. Being able to summon immediate help can make a difference.
It should also be noted that social media can and does play a large and ever-increasing role in people’s day to day lives, and occupies an important niche in many people’s social interactions with others. If you recognize the signs and indicators of suicide or suicidal ideations in the posts of someone on social media, reach out to them, or contact the social media site directly if you notice concerning updates.
SOURCES
Suicide Prevention. (2017, March). Retrieved June 9, 2017, from
https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml
Teresa King
PMHC Intern
As a doctoral psychology intern I have noticed that many clients are being ordered to have genetic testing to assist the physician to determine the proper diagnosis as well as what medication may be more appropriate. It has been relatively recently that research has been initiated on the MTHFR gene, as well as the enzyme it produces, and the effects caused by its malfunction. MTHFR stands for MethyleneTetraHydroFolate Reductase, and its acronym is used interchangeably to denote either the gene or the enzyme it produces. The gene is found on the short arms (there are 2- 1 each from the mother and father) of Chromosome 1. The gene is made up of 20,373 base pairs, and the MTHFR enzyme produced by the MTHFR gene helps to produce pyrimidines, which are the building blocks of DNA nucleotides.
When the MTHFR gene is mutated, the enzyme it produces is not entirely correct. These mutations tend to be very small and minor; however, they can create a variety of health problems and issues. For the enzyme to work properly it has to be perfect since even the smallest mutation of the gene sequence can produce severe chronic health effects. 0.000098% is the threshold for mutation, or just 1 mistake in the 20,373 steps of the MTHFR gene code.
The most common mutations are found at positions 677 and 1298 on the MTHFR gene, with the mutation being capable of affecting one, the other, or both positions. It should be understood that MTHFR gene mutations can cause absolutely no symptoms at all, or they can cause severe, irreversible issues like Down’s syndrome, pulmonary embolisms, and Parkinson’s. While research is ongoing in an attempt to determine exactly which conditions are caused by or attributable to mutations of the MTHFR gene sequence, it has been determined that there are quite a few medical conditions and syndromes that are related to mutations in the MTHFR gene sequence. A partial list:
While this list is not all inclusive, it does reveal the depth of the importance of testing to determine if MTHFR mutations have occurred, the particular location of the mutation, and what treatment protocols should be considered with regard to the expressed health issue. For more complete and in-depth info, please go to http://www.mthfr.net for the latest research on MTHFR and its associated effects on health.
Sources
Lynch, B., MD. (2012, January 25). MTHFR Mutation. Retrieved June 12, 2017, from http://mthfr.net/
Teresa King
PMHC Intern
While the suicide rate in America trended steadily and solidly downward during the ‘80s and ‘90s (likely attributable to new, more effective antidepressants with fewer side effects), a significant turnaround with an increase was noted between 1999 and 2014 (Bichell, 2016), with some fluctuation between 1999 and 2007; from 2007 onward, however, the rates rose sharply with a particularly marked increase in the rates of children aged 10-14 (Middlebrook, 2016). While it is true that suicide rates climbed steadily in the 15 years from 1999 to 2014 for every age group under 75, the one demographic that stands out most is young girls ages of 10 to 14. Of particular concern is the fact that while they are a very small percentage of total suicides, their group experienced the most dramatic increase, with rates actually tripling over 15 years from 0.5 to 1.7 per 100,000 people (Bichell, 2016). While this is quite an alarming trend, the fact that there are nearly 400 attempts for every completed suicided raises the stakes to an even higher degree (Cutler, Glaeser, Norberg, 2001).
A singular cause has been difficult to pin down: a difficult economy, with attendant joblessness/unemployment making it more difficult to access health care and/or treatment; lack of appropriate coverage under personal health insurance policies; and a shift in the drug of choice among recreational users from crack and cocaine to heroin and prescription narcotics (Bichell, 2016). A positive correlation between suicide and homicide was noted, as was the fact that while girls attempt suicide more often than boys, it is the boys who complete it more often. Blacks have lower rates of attempts and completions than whites, rural states have higher rates of suicide, and firearms are by far the most utilized method in successful suicides (Cutler, et al, 2001).
The reasons behind the “why” of youth committing suicides are equally difficult to ascertain. Rationalization of the act in the context of an unhappy life that has less value than death, as well as an attempt to exert some measure of control in the face of feeling helpless/powerless or to elicit a response (“looking for attention”) have been positively identified, as has the combination of impulsive behavior and availability of firearms or other equally accessible methodology; or even, incredibly, imitating the suicide of a close friend or loved one (Cutler, et al, 2001). Earlier puberty has also been advanced as a possibility, due to so much change occurring all at once. While boys tend to peak around 13, with girls the peak age of puberty drops to 11, with some studies indicating that girls may be starting their periods even earlier. It has also been shown that there is a direct correlation between the onset of puberty and the onset of psychological disorders, particularly depression, which is a huge risk factor for suicidal ideations, and due to the shift in the age of onset for puberty, girls may be experiencing a myriad of psychological issues in addition to anxiety and depression at a much younger age than ever before encountered (Bichell, 2016).
This recent trend toward an increase in suicidal ideation, attempts, and completions is disheartening, to be sure, but it can be corrected. Parents absolutely must look to their children’s welfare, and be attentive to the needs of their children. While they should definitely talk to their children regularly to ascertain the presence, if any, of issues that may be of serious concern, parents should also be ready to just listen, and let their children talk without being pressured. There are many issues faced by children that parents too often tend to forget from their own childhood, and the unavailability of parental support and reassurance can be a contributing factor in allowing children to slip towards an irreversible event that can be readily avoided.
References
Bichell, R. E. (2016, April 22). Suicide Rates Climb In U.S., Especially Among Adolescent
Girls. Retrieved May 10,
2017, from http://www.npr.org/sections/health-shots/2016/04/22/474888854/suicide-rates-climb-in-u-s-especially-among-adolescent-girls
Cutler, D. M., Glaeser, E. L., & Norberg, K. (2001, March 15). Explaining the Rise in Youth Suicide. Retrieved May 10, 2017, from https://papers.ssrn.com/sol3/papers.cfm?abstract_id=263440
Middlebrook, H. (2016, November 03). Suicide deaths on the rise in kids. Retrieved May 10, 2017, from http://www.cnn.com/2016/11/03/health/kids-suicide-deaths-increase
Teresa King,
PMHC Intern
“The way to predict future behavior is to look at past behavior.” This statement is often hammered into the heads and hearts of anyone seeking to establish long-term careers in the behavioral and psychology fields. Our psychological tests and empirical research are guided and structured to line up succinctly with this ideological concept. But have we essentially highlighted our dispensability among this generation, when unconsciously promoting that theory?
I recently read an article in the BBC news, which discussed the Durham police department in England who are in the process of piloting a new program where an app would assess the risk of a potential suspect. According to the article, the police department will use a cell phone app to determine the probability a suspect will commit a violent act if not detained. During testing, the app called “Hart” was accurate 98 percent of the time when predicting low risk offenders and 88 percent when predicting high-risk offenders.
I must admit as a proclaimed Humanist, I had a knee jerk reaction when I first started reading this article. The thought of a mathematical equation making decisions with serious consequences on flesh and blood people frightened me. Images of the movie thriller, “Minority Report,” where an innocent man being found guilty of murder by a cold computer came to mind. However, as I read the article and understood the accuracy of the algorithm used in the app, I felt that my bias towards machines might have been illogical. This is natural because human beings are at times illogical and our conclusions are often wrong. When we watch the news, we constantly see evidence of our “wrong” and illogical behavior. We see examples of the law, being enforced unfairly, based on gender, race and/or class. Moreover, our biases do not start and end with law-based experiences. We also observed biases in how we hire employees, how we pick our mates, who we associate with, which political parties we support etc. And if we were to think about the Hart program more logically, we would come to the conclusion that if we were to be pulled over by a police officer, we would probably more likely prefer to be judged by a cold, heart-less, algorithmic computer rather than a hot blooded cop who is having a hard day.
We are living in an age where things are becoming more and more automated, and I believe we can be more rational in how we judge the computers and machines that are taking on roles once performed by humans. Still lingering on the morality fence with Carl Rogers and Hippocrates? Then consider the following example: we humans are somewhat okay with the fact that 1.3 million people are killed every year in automobile accidents and accept that these accidents are a part of our lives as acceptable human error. If a driverless car were to hit and kill a child running into the streets after his ball, it would be safe to guess there would be a collective public outcry to end to driverless cars. Ultimately holding machines more accountable to the persons who made and designed them. The fear of machines come from an emotional part of our minds rather than the logical part. Therefore logically speaking, I am sure machines will make mistakes; but if the statistics show, they can make less mistakes than we humans can, should we not ethically yield and refer to their specialties?
Reference: http://www.bbc.com/news/technology-39857645
Dianne Rapsey-Vanburen, MA
WKPIC Doctoral Intern
Anxiety refers to the response of the body towards a stressing, unsafe, or unfamiliar circumstance. It describes the sense of distress, nervousness, or fear that one feels before an important event. Being nervous about a job interview or terrified over an upcoming test is healthy and is commonly referred to as “normal anxiety.” Anxiety of this nature encourages people to adequately prepare for situations they are uneasy about and ensures that one stays prepared and attentive. Anxiety can develop to levels that need health or medical attention (Wu, Tang & Leung, 2011). Anxiety Disorder can be devastating. The anxiety that may require treatment is usually overwhelming, absurd, and inconsistent to the situation. People who suffer from it feel like they have no control of their sentiments, and can include severe physical symptoms such as nausea, headaches, or trembling. If normal anxiety develops to be disproportionate and starts to recur and affect one’s daily life, it is referred to as reaching clinical levels and termed a disorder.
Trauma refers to an emotional response to a devastating circumstance such as physical or mental abuse, rape, accident, natural disaster, etc. After an event has occurred, denial and shock are common. Unforeseen emotions, flashbacks, stressed relationships and some physical symptoms such as nausea and headaches are some of the long term responses to trauma (Baldwin & Leonard, 2013). Traumatized people have problems moving on with their lives and may sometimes require guidance and intervention help from psychologists and other health care professionals to move on.
Some people who experience traumatic events may develop an anxiety-linked disorder referred to as Post-traumatic stress disorder (PTSD). Individuals who suffer from PTSD encounter a hard time in the aftermath of the traumatic event that continues to impact them even after the event has subsided (Ardino, 2011). Continuous anxiety and difficulty in concentration are some of the prevalent symptoms in people suffering from PTSD.
It is important for psychologists and other professionals in the health care field to truly comprehend the relationship between trauma and anxiety (Hughes, Kinder & Cooper, 2012). Clinical Psychologists perhaps have an ethical responsibility to go beyond a mere text book understanding about this relationship if they are to become effect in their treatment approach. In other words simply knowing what to call something by name does not terminate the treatment process. That may also be why psychology is referred to as a helping field (operative word being help) not just a naming one. The treatment of both trauma and anxiety entails a detailed assessment and creation of a treatment plan that meets the distinct needs of the sufferer. It is essential for the health practitioners to have an in-depth understanding of both the conditions so as to be better placed to help the people suffering from these conditions. Because of the differences in experience and repercussions of the trauma, the treatment differs and is tailored to the symptoms and requirements of the person (Hyman & Pedrick, 2012). Psychologists must have a good understanding to ensure that their patients are able to lead a more balanced and functional life again. Health practitioners may have a difficult time in differentiating the symptoms of anxiety and trauma. Therefore, health practitioners must become proficient and informed on how to handle people suffering from anxiety and trauma.
Possessing sufficient understanding that can assist differentiate between anxiety and trauma will improve the outcomes of some of the interventions applied to assist those affected. In most cases, people suffering from anxiety disorders have previously been affected by a certain traumatic event. Thus, it is possible that these people will exhibit some symptoms that are the same during the phase they suffered from trauma. It is important for the health practitioners to understand the relationship between anxiety and trauma to ensure that they give the correct medications and that the appropriate intervention procedure is used. More importantly, we need to have in-depth knowledge and understanding so as not to re-traumatize those who are entrusted under our care. There is the high probability that many on your caseloads and even those you work around, you will have had traumatic past experiences. Your approach in caring for these individuals can be a direct reflection of your skills and understanding about the anxiety/trauma relationship. Moral ethical rule number one: Do no (more) harm.
References
Ardino, V. (2011). Post-traumatic syndromes in childhood and adolescence: A handbook of research and practice. Chichester, West Sussex, UK: Wiley-Blackwell.
Hughes, R., Kinder, A., & Cooper, C. L. (2012). International handbook of workplace trauma support. Chichester, West Sussex: Wiley-Blackwell.
Hyman, B. M., &Pedrick, C. (2012). Anxiety disorders. Minneapolis: Twenty-First Century Books.
In Baldwin, D. S., & In Leonard, B. E. (2013). Anxiety disorders.
Wu, K. K., Tang, C. S., & Leung, E. Y. (2011). Healing trauma: A professional guide. Hong Kong: Hong Kong University Press.
Dianne Rapsey-Vanburen, MA
WKPIC Doctoral Intern
If you would like to become more productive while at the same time having more free time for yourself, you need to etch the ratio 52:17 into your mind. According to an article in the BBC health Column, the ratio 52:17 represents the average time spent working and relaxing for top earning performing employees. That is, for every fifty-two minutes they spent working on the job, they had seventeen minutes of relaxation, self-care time. The article also outlines that the top ten percent of valuable performers at companies do not necessarily spend more time working than other low performing workers, instead they have periods of deep intensive work followed by short resting periods.
After reading this article I thought about work, productivity and more importantly effectiveness. I realized that there was a significant difference between all three. It felt like an epiphany. Living our lives in an industrialized culture, it is usually ingrained that hard work lasting for long hours was productivity, and the less sleep you got meant you were being a good producer. I have seen many people brag about how many long hours they worked and how little sleep they got. They took pride in their work ethic without paying much attention to the actual results of that work. Who could blame them? If they came in early to work, left late, and looked busy for the ten or twelve hours they were at work, they would most certainly be considered for a promotion, a raise, awards, or perhaps coveted privilege employee of the month parking spots. Not hating the game, just highlighting some players. However, large high volume producing companies like Google, Apple and Starbucks have already aimed to shift that old pods, fully equipped gyms, yoga classes and literally free lunches to staff? A happy worker is a productive worker. Simple deductive reasoning, but not everyone is on board just yet.
Unfortunately this specific article, completely contradicts the mindset behind that type of thinking. It said that most managers and supervisors could not even tell the difference between employees who worked 80 hours a week from those who just pretended to. It also cited one study done from the Illinois Institute of Technology which said that scientist who spent 25 hours in the workplace were no more productive than those who were in the workplace for just 5 hours. This showed that there was a clear distinction between work and productivity output. There is not a direct correlation between each of the two.
In the field of Psychology shouldn’t the concept of caring for our employees be greater emphasized? After all we are in the ‘taking care of people business’. If we are unable to extend care to ourselves and those around us, how on earth are we to offer those services to others in need? Can you teach others to fish without having a fishing rod (and not using the rod as a whip).
“Sometimes the most important thing in a whole day is the rest we take between two deep breaths. ” – Etty Hillesum
Reference:
http://www.bbc.com/capitalstory/20170613-why-you-should-manage-your-energy-not-your-time
Dianne Rapsey-Vanburen, MA
WKPIC Doctoral Intern