Friday Factoids Catch-Up: Bringing a knife to a gun fight (with a bully!)–How solutions to bullying have not kept up with our times

We can all agree bullying is cruel, and social rejection is painful. Many of us have been victims of bullying, and know firsthand how difficult dealing with bullying and social rejection can be. It is harder and painstakingly difficult as a clinician (some of us parents ourselves) when we are guiding child clients through bullying experiences, and we face vicariously reliving these buried experiences. It can leave us feeling again overwhelmed and helpless. What is also interesting (and perhaps concerning) is that there seems to be a growing trend of parents seeking assistance from clinicians and other health care providers, to fill out documents for ‘Homebound’ status from schools citing “bullying” as reasons for requests.

 

For those of us unfamiliar with  educational Homebound status, it is a school based program where the state provides in-home tutoring by board certified teachers, 1-2 times per week on a temporary bases (typically ranging from 3-6 months and/or approximately 1 semester period) usually dedicated to medical and/or adverse behavioral circumstances. The belief perhaps by both victim and parents alike, is that the bullying would have subsided (or possibly found alternative new targets,) and the negative effects from the whole unwanted experience would have moderated by the beginning or fresh start of the next semester. Is this wishful thinking or innovative maneuvering?

 

While parents’ desperate attempts to finding alternative solutions to bullying problems through clinicians and services like Homebound sound a bit extreme, consider the fact that reported incidences of bullying have not only increased exponentially, but has also significantly evolved since most of our own experiences as children. Social media has serendipitously become the platform where bullies can become stronger and more empowered. Bullies have upped their ante, whereas the school systems appears to be struggling with an ineffective, outdated “Zero Tolerance” slogan, that is perhaps more comparable in deterring bullying as wearing a scarlet letter on one’s chest in today’s society.  Even the scripts seem to have not changed, remember: “Some people bully because they are bullied at home, and just looking to project that anger outwardly.”

 

As a child these statements were not comforting to me, and saying them to another child as an adult, seems significantly undermining to their experiences. Additionally, while schools are supposedly mandated to investigate incidences of bullying when reported, attaining evidence via social media outlets becomes hampered by tools such as “Snapchat,” in which the social media thumbprint “disappears” after being viewed. To add insult to emotional injury is the fact that the education system is not the only ones who have failed to keep up with the evolving intervention times. The field and persons specifically tasked with studying and predicting human behavior, have also failed to keep up with social media bullying issues. Clinicians and other behavioral health care providers lack the tools, resources and/or adequate trainings to solve this bullying epidemic.

 

As a parent, I became heartbroken after reading an article in the BBC, which accounted the ordeal of a father whose daughter committed suicide after being bullied for most of her teenage years. According to the article, the girl started being bullied at thirteen years old when she confided in a friend about her sexuality. The friend then betrayed the girl’s trust by letting others in the school know about her secret. That’s when other students at the girl’s school began to bully her. The bullying got so bad the girl left her school, but she continued to interact with her classmates through social media. According to her father, his daughter ‘just wanted to be loved—she wanted to show she was a good person’. In response to his daughter’s suicide, the father of the girl responded by taking a picture of what would have been his daughter’s 18th birthday, and posting it on social media. His goal was to raise awareness on the terrible effects of bullying.

 

As a child, I wanted bullying to stop. As a parent, I want to see an end to bullying more than ever. As a budding clinician in the behavioral field, I believe it is our ethical responsibility and hope to ‘do more’.  I greatly support the efforts to end bullying, and I am encouraged by the anti-bullying projects I now see—all of which were not around when I was a child. However, I believe we need a more comprehensive approach to combat bullying. For example, there are many messages that teach younger people why not to bully, but there should be more messages which teach younger people how to cope with bullying.

 

Finally, setting the example has always been the ideal path towards long-lasting change. Often times micro, passive, as well as relational social aggressions have a fixed place in our work environment. We tend to look at co-workers who have difficulty with such experiences as “weak” and stay clear of the situation, lest we be labeled or thought of as childish or immature. Grateful to be uninvolved in work conflict of any sort, we usually find solace in our apathy and inactiveness. “Bad things happen, when good people stand by and do nothing.” After all, isn’t a coworker or boss who exhibits workplace aggression, simply not a bully who has weathered the storms of times to become successful in their personal trade?

 

As a parent with a son entering his schooling years, I plan to teach him how to treat others with care and respect—to treat them in the same way he would like them to treat him in return. It was a lesson I greatly valued and was taught by my own parent, as a child. Unfortunately, that is all I have to offer him in this fight, for now.

 

BBC News Article: Bullied daughter Julia Derbyshire ‘just wanted to be loved’

 

Dianne Rapsey-Vanburen, MA
WKPIC Doctoral Intern

Understanding Anxiety and Trauma

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

 

Article Review: Frightening Truths About First Episode Psychosis: Results From a 2011 NAMI Survey

 

 

For many psychologists, greater experience comes at a costly price tag of desensitization. When conducting a routine structured interview, the phrase “Do you often hear or see things that others cannot?” would hardly elicit a noticeable response reaction, from even the most novice clinician. We may unintentionally disregard that the field of Human Services often times involves evaluating very real, sometimes very difficult human experiences.  Treating these experiences with the great humility and reverence they deserve can unfortunately sometimes fade with time.  It is therefore imperative that clinicians be hypervigilent and proactive in submerging themselves into research studies and literature, which aim to connect and help clinicians to understand these distressing experiences. Experiences such as psychosis can be extremely frightening, confusing and deeply personal not only for those experiencing it, but also for those closely related and wanting to help, like friends and family members.

 

The National Alliance on Mental Health conducted an online survey of people who experienced psychosis or witnessed a friend or family member have an episode of psychosis. The 2011 survey followed another NAMI survey that found that, on average, there is a nine-year gap between a person’s first psychotic episode and the time they begin to receive treatment for their diagnosis.

 

The 2011 NAMI survey also focused on finding the possible reasons why people with psychosis go close to a decade before receiving treatment, and possible solutions to solving the problem. First, there was the issue of lack of knowledge about psychosis. According to the survey, approximately 40 percent of the people who had psychosis said they were the first to recognize the problem themselves. These people reported that they realized something was wrong but they did not know what it was, due to lack of understanding about psychosis in general. This problem was compounded by the fact that many people who experience psychosis tend to isolate from others. According to the NAMI survey, around 20 percent of the responders reported that they did not receive help from friends or family when they had their first psychosis episode (NAMI, 2011). Lack of knowledge also proved to be a problem among family and friends. Just like the patients who experience a psychotic episode, family and close friends have a difficult time understanding and recognizing the symptoms of psychosis when they see it, making it difficult to get the help needed for their loved one.

 

A second challenge that prevents psychosis sufferers from receiving treatment is the stigma attached to mental illness. Again, this problem stems from lack of knowledge about psychosis. Respondents to the NAMI survey said that the issues they found the most challenging were confronting the stigma of mental illness, telling others about their psychosis, and worrying about no longer being taken seriously by others.

 

All these issues lead to a similar problem, which is, mental health professionals do not become a part of the treatment of patients who have psychosis, until many years down the line after their first episode. This is a significant obstacle to the treatment of psychosis because many of the respondents to the survey suggested that finding the “right” doctor, keeping appointments, and taking medication were very helpful in their treatment.

 

Observing the results of the NAMI survey, this writer believes that a comprehensive approach is necessary to solve the problem of delayed diagnosis of psychosis. According to the survey, many of the respondents said that they first received information about psychosis online. As such, putting relevant information online would be a good first step in educating the public about psychosis. Also, having an educational blitz in schools, workplaces and other institutions about psychosis would go a long way in both destigmatizing mental illness, and providing relevant information for people to get help for themselves and their family members.

 

Finally, understanding that psychosis can be a frightening, confusing, and very personal experience for any individual. The human exchange of simply gaining information and marking a check symbol in some box cannot (hopefully) be a comforting solution for any clinician, when uncovering someone’s experiences with psychosis.  In fact, if the tables were turned, what kind of qualities would you require from the person sitting across from you, before you felt comfortable enough to open up about such a deeply profound experience?

 

“The psychological equivalent to air, is to feel understood” – Stephen R. Covey

 

Reference: https://www.nami.org/psychosis/report

 

 

Dianne Rapsey-Vanburen, M.A.
WKPIC Doctoral Intern

 

 

Friday Factoids Catch-Up: Differentiating Subgroups of ADHD

Penn State University (2016) researchers recently found that young adults with Attention-Deficit/Hyperactivity Disorder (ADHD) demonstrate subtle physiological signs that may help provide a more accurate diagnosis and possible identification of types of ADHD.  Their findings indicated that while engaged in a continuous motor task, individuals with ADHD had greater difficulty inhibiting motor responses and produced more force during the task compared to controls.  This research allowed for a more precise measure of motor responses compared to previous assessments based on key-press response.  Additionally, the amount of force was related to the self-report of ADHD symptoms of inattention, hyperactivity, and impulsivity.

 

The goal of this research was reportedly to help differentiate subgroups of those diagnosed with ADHD, which aims to inform treatment and offer diagnostic specificity.  The use of continuous performance tests (CPT) in ADHD assessments has yielded variable reviews, although the use of CPT in research has provided valuable information specific to ADHD (Bjorn, Uebel-von Sandersleben, Wiedmann, & Rothenberger, 2015).  Regardless, research indicates that CPT provides information specific to sustained attention and impulsivity, and can be utilized as a tool to aid diagnosis and per Penn State researchers, possibly identify more subtle signs that could directly inform treatment and interventions.

 

References

Albrecht, B., Uebel-von Sanderslebem, H., Wiedmann, K., & Rothenberger, A. (2015). ADHD history of the concept: the case of the continuous performance test. Current Developmental Disorders Reports, 2(1), p. 10-22.

 

Penn State. (2016). Inhibitory motor control problems may be unique identifier in adults with ADHD. Retrieved from https://www.sciencedaily.com/releases/2016/11/161116103443.htm

 

Dannie Harris, MA
WKPIC Doctoral Intern

 

 

Friday Factoids Catch-Up: Impact of Trauma on Later Mental Illness

Palmier-Claus, Berry, Bucci, Mansell, and Varese (2016) found childhood adversity, described as neglect, bullying, and emotional, physical, or sexual abuse, was 2.63 times more likely to have occurred with individuals with bipolar disorder.

 

They note the effect of emotional abuse was particularly robust, with emotional abuse being 4 times more likely to have occurred with individuals with bipolar disorder.  Given the severity, course, and deleterious impact of this disorder on the individual and their family, highlights a need to identify risk factors that can inform treatment.  Similar findings have shown a link between childhood adversity and other mental disorders.  Specifically, Matheson, Shepherd, Pinchbeck, Laurens, and Carr (2013) found medium to large effect size of childhood adversity with individuals with schizophrenia.

 

Thus, for both bipolar disorder and schizophrenia, research suggests childhood adversity as a possible risk factor for development of these disorders.

 

References

Matheson, S. L., Shepherd, A. M., Pinchbeck, R. M., Laurens, K. R., & Carr, V. J. (2013). Childhood adversity in schizophrenia: a systematic meta-analysis. Psychological Medicine, 43(2), 225-238.

 

Palmier-Claus, J. E., Berry, K., Bucci, S., Mansell, W., & Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. The British Journal of Psychiatry, 209(6), 454-459.

 

Dannie Harris, MA
WKPIC Doctoral Intern