Depression In Men 2 While the volumes of literatures on the impact of depression and how it is processed across gender are ma

Depression In Men 2 While the volumes of literatures on the impact of depression and how it is processed across gender are ma

Depression In Men 2

Contents

TOC o “1-3” h z u HYPERLINK l “_Toc379014987” Abstract PAGEREF _Toc379014987 h 1

HYPERLINK l “_Toc379014988” Introduction PAGEREF _Toc379014988 h 1

HYPERLINK l “_Toc379014989” Overview of Depression in Men PAGEREF _Toc379014989 h 2

HYPERLINK l “_Toc379014990” How Men Process Depression PAGEREF _Toc379014990 h 3

HYPERLINK l “_Toc379014991” Antagonizing and Blaming Others PAGEREF _Toc379014991 h 3

HYPERLINK l “_Toc379014992” Discontent with Himself PAGEREF _Toc379014992 h 3

HYPERLINK l “_Toc379014993” Seeking Stimulation PAGEREF _Toc379014993 h 4

HYPERLINK l “_Toc379014994” Escaping and Avoiding PAGEREF _Toc379014994 h 5

HYPERLINK l “_Toc379014995” Social and Cultural Influences in Male Depression PAGEREF _Toc379014995 h 5

HYPERLINK l “_Toc379014996” Cultural identity PAGEREF _Toc379014996 h 6

HYPERLINK l “_Toc379014997” Cultural disparities PAGEREF _Toc379014997 h 7

HYPERLINK l “_Toc379014998” Meta-analysis, quantitative and qualitative studies PAGEREF _Toc379014998 h 7

HYPERLINK l “_Toc379014999” Discussion PAGEREF _Toc379014999 h 8

HYPERLINK l “_Toc379015000” References PAGEREF _Toc379015000 h 8

AbstractWhile the volumes of literatures on the impact of depression and how it is processed across gender are many, none has focused on the way men process depression. This paper proposes that men process depression in very ad hoc and untellable ways as compared to women and than men either Antagonizing or Blaming Others, is content with themselves. Seek Stimulation and or use scapegoats or avoid depression. It also proposes that t men process depression differently across cultures and makes a cross cultural analysis to determine the influence of culture on how men process depression. A Meta-analysis was conducted to determine the bottom line of the study. A conclusive results was reached at that gave the assumption of the study a new directions

Key words: gender, depression, processing, culture, longitudinal etc

IntroductionThe prevalence of depression in contemporary society appears to be on the increase. Some scholars posit that depression may indicate a symptom of contemporary times, which are typified by alienation bleak economic situations, and absence of strong familial attachments. It is not known certainly whether depression affects women and men differently. In general, as both genders regularly operate in dissimilar social contexts, the two have a propensity to develop dissimilar emotional dispositions as well as, personality traits. For that reason, their responses as well as coping mechanisms to depressing situations may vary. Owing to the socialization patterns prevalent in modern society, male depression assumes a different look (Rowan, 2009). This paper posits to investigate how men process depression in different ways than women and whether there are different symptom presentations in men.

Overview of Depression in MenIt is evident that men do all they can in order to evade appearing vulnerable, indecisive, or weak. Whereas women have a tendency to process or think through their feelings in the event that they experience depression, men have a propensity to take action. Depressed men usually do not confess to feeling miserable, although they might feel irritable or fatigued. They usually do not have a name for their emotions, but they recognize they sense deadened inside. As a result, they fall back on activities with the aim of distracting themselves from their depressing feelings. Occasionally these activities may be adaptive, such as looking for a job if he is without a job. However, in other occasions men may distract themselves in negative ways, such as avoidance, acting out, or denial. They are unenthusiastic to assume responsibility for their underlying sense of depression, which they do not admit to, or name (Paulson & Bazemore, 2010).

Even if the correlation between women and depression is stronger than that of men, the incidence of depression in men is widespread. The problem is that the majority of men do not search for assistance in case of depressive disorders as women do. Men are also much less keen to speak concerning their misery than women are. Secondly, men do not respond in the same manner as women do in the event of depression. When women are depressed, they tend to feel worthless, tender, and hopeless. Men in contrast have a propensity to feel irritated, whereby they may work excessively and more often than not behave aggressively (Rollock, 2009).

How Men Process DepressionAntagonizing and Blaming OthersMen in depression shield against their feelings of depression at all costs and consequently lead them down the path of fault finding in other for his misery. Men dread living with their sense of dysphoria, and know that at a certain level; they cannot accommodate any more experiences. This makes men feel increasingly worse about themselves or increasingly hopeless concerning the future. Consequently, to defend against these circumstances, men go on the offense (Gilbert, 2010).

The major target of this blaming conduct is their family, the ones they are closest to, even though others might bear the blame too. Men generate conflict with others apparently unexpectedly although they may as well meditate over a matter and bring it up repeatedly with no resolution. Relationships might be sorely attempted during this stage of a man’s depression, and yet bring about domestic violence. For the period of the conflict men, might sense a feeling of authority and give their own feeling of misery a source as well as a name. An identifiable and tangible target is easier to handle than the edgy feeling of emptiness that they may harbor inside. The negative aspect to attacking other people, however, is that men end up feeling increasingly isolated and alienated as depression intensifies (Rollock, 2009).

Discontent with HimselfA man coping with depression might express intense discontent with himself, his achievements in life, as well as his ability to manage the issues of daily life. The man may adopt a negative way of framing his experiences in life. A man might feel that he has failed to see opportunities experienced by other people and that he may have failed as a provider and protector. He perceives life as a half empty glass, and has trouble in rewarding himself for his realistic accomplishments in life. He might find it demanding to view his setbacks as simply temporary or as a chance to rise above his unpleasant experiences. To a man, failure is a cause of immense shame. When shame dominates the life of a person, the depressing thought process is inflated. This brings about defensiveness, rage, self-destructive conduct like substance abuse. The man may probably decline to recognize the fundamental predicament as depression, since that too might be a cause of shame. Regrettably, he might more effectively deal with his depression through exploring it directly instead of taking up self-blame and avoiding investigating the true cause of his misery (Gilbert, 2010).

Seeking StimulationDepression implies intimidation to a man’s customary sense of masculinity. The man feels vulnerable, weak, and not capable of being decisive, and this is offensive to him. Consequently, a man might turn to inflated hyper-masculine conduct to deal with his inner apprehension of appearing helpless. A man hates feeling unproductive, so he adopts exceedingly stimulating experiences to persuade himself that he is powerful and vital. Consequently, many depressed men may seek places to express rage, participate in substance abuse, and search for sexual stimulation (Frosh, 2009).

While in depression, a number of men may excessively drink alcohol because it provides them a fleeting experience of security, a way to flee the feared deadened sense of depression. In the same way, they might abuse marijuana or other stimulating drugs for instance, methamphetamine or cocaine. Unfortunately, alcohol as well as other drugs gives a momentary sense of euphoria and flight from depression. Since it feels good, a man might go back to it frequently consequently establishing an addictive pattern. Anger presents a similar sense of stimulus, not only psychologically but also neuro-chemically. Men allege a sense of authority as well as being alive throughout the adrenaline rush connected with fiery rage. Sexual experiences might as well present a comparable rush. Nevertheless, the result is at all times the same, the temporary sense of security does not cure the underlying depression. In reality, it distracts the man from engaging in conduct that will deal with depression in a permanent and healthier way (Gilbert, 2010).

Escaping and AvoidingWhen men feel awful, it is customary to try to seek a method of escaping from the depressing experience. Nevertheless, depression may be dealt with therapeutically, and to avoid addressing it leads to perpetuating it. Men while in depression employ an infinite variety of escape and avoidance conduct, anything to pass the time in order that they may not have to experience the empty feeling of depression. For instance, a depressed man might dissociate himself from a situation for an extended duration of time. He might spend long hours reading, online, watching TV, or He might drink excessively or abuse drugs. He might have a string of sexual affairs. However, there are healthier tactics for coping with depression (Frosh, 2009).

Social and Cultural Influences in Male DepressionThe depression sociology embraces the cultural contexts in which people survive and the social stressors that individuals experience as a component of life. The sociological characteristics of depression are influenced by and manipulate other biological as well as psychological characteristics of people’s lives. In the past, it was perceived that depression principally plagued persons in developed Western countries and that non-American-Euro cultures did not experience this disorder. On the other hand, ethno medical studies propose that this opinion might have more to do with cultural opinions of what symptoms are tagged as a depressive disorder, how incidences of depression are documented for statistical functions, and how depression is perceived in particular cultures. For instance, in India, an extensive array of distress disorders are classified as depressive disorders, while in Japan, the notion of mental illness is deplorable and few men would confess to having it. Even in the U.S, incidence rates of depression might be influenced by cultural contexts (Gilbert, 2010).

Gender roles

Several cultures have inflexible gender roles that characterize anticipated behavior. Men’s roles exist principally outside the house, while the roles of women are explicitly in the home. In such cultures, women might not leave their homes except when accompanied by a male member of the family. Equally, men by no means go into the kitchen. If a man from this kind of culture experiences a social stressor which compels an alteration in roles or a dispute to the status quo, such stress may cause the man to develop into depression. For example, in the event that a husband from a society with inflexible gender roles loses a spouse, he might not discern how to take care of his children’s daily needs for instance feeding, or bathing (Rollock, 2009).

Cultural identity

Cultural identity frequently influences the extent to which an individual demonstrates somatic symptoms of depression. This means that, some cultures may be contented reporting symptoms of depression that are somatic in character rather than mental. For instance, many depressed Chinese men complain of physical discomfort, feelings of internal pressure, as well as symptoms of dizziness, fatigue, and pain. Likewise, depressed Japanese men habitually complain of headache, neck, and abdominal pain symptoms. Even in Western nations where depressive disorders are increasingly acceptable, scholars have hypothesized that a number of chronic conditions such as fibromyalgia, chronic pain, chronic exhaustion syndrome, may be somatic types of a mood disorders than real physical problems (Frosh, 2009).

Cultural disparities

Cultural disparities in help-seeking conduct may manipulate depression treatment. For instance, non-Western men frequently utilize indigenous practitioners for treatment of complaints and Western-educated doctors for treating disease. If emotional troubles are not regard as within the sphere of disease, depressed men may not readily look for mental health or psychiatric care for symptoms of depression. Since the public discourse concerning depression is increasingly widespread in Western societies, it is increasingly socially tolerable to suffer depression, and more men are willing to ask for help. On the contrary, mental illness is regularly increasingly stigmatized in other societies (Gilbert, 2010).

Meta-analysis, quantitative and qualitative studiesWhile the meta-analysis was generalizable over a large population, the actual Meta analysis may not be effective in the prediction of the result of a single study; therefore, it was imperative to conduct another study. It is also advisable to note the sources of bias in the study were not easy to control in the meta-analysis. This might have affected the results and direction of the study. However, the best evidence meta-analysis was used to correct the inherent weakness of meta-analysis. The methodological selection criteria could have introduced the unwanted subjectivity that weakened the purpose of the study. On the other hand, the qualitative analysis in the study was useful for providing a clear picture of the dispirit in the cultural influences of depression and the behavioral disparity of the depression processing across gender, however it was not effective as the results from the quantitative study could not be gene raised. Generally, the results produced by the quantitative study were very realistic and could be used to developed theory inductively unlike the qualitative study. However all the three studies were important in arriving at the desired conclusion as the weaknesses of one method was compensated by the other methods?

Discussion

Ethno medical research proposes that cultural disparities in placing much focus on oneself as well as one’s place in social hierarchies are associated with the incidence of depression. Men should understand that depression does not denote that one is feeble or that one is untreatable or fanatical, but that one is experiencing a problem that needs to be dealt with prior to causing further damage. This hidden depression is fundamentally a disorder of self-value and self-esteem. Healthy self-value is fundamentally internal. It is the capability to value oneself not owing to what one possess or has the ability to do.

ReferencesFrosh, S. (2009). Masculine Ideology & Psychological Therapy. New York: Routledge Press.

Gilbert, R. (2010). Depression: Evolution of Hopelessness. New York, Guilford.

Paulson, J, & Bazemore, S. (2010). Prenatal and Postpartum Depression in Fathers and Its Association with Maternal Depression: A Meta-Analysis. Journal of the American Medical Association. 19; 303(19):1961-9.

Rowan, J. (2009). Treating the Male Psyche. New York: Routledge Press.

Rollock, T. (2009). The Role of Contextual Differences, Gender, Ethnicity, Emotional Content, in Expressive, Physiological & Self-Reported Emotional Reactions to Imagery. Emotion & Cognition, 15, 16–19.

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Descartes believed that reason is a gift every human being poses and that knowledge cannot be only be attained by books

Descartes believed that reason is a gift every human being poses and that knowledge cannot be only be attained by books

Name

Course

Professor

Date

Philosophy

Question oneDescartes believed that reason is a gift every human being poses and that knowledge cannot be only be attained by books, but through the application of reasoning. His books presented complex scientific and philosophical ideas in a way that only the least sophisticated readers could understand. Due to his believe that every human being possessed the gift of reason, he believed that every human being would understand his arguments in his books. He at sometimes wrote his books in French and not in Latin so that people with formal education could easily understand him. In his evil demon conjecture, he stated that an evil demon is capable of tricking us to believe that the world we all perceive with all our senses is real. However, even in such instances, there is no one point when a human being is not thinking and due to these thinking, then human beings exist (Cogito ergo sum).Question twoSpinoza believed that there existed no dualism between God and the whole world. There is no need of people going beyond the present experience to seek for a being existing outside it. He said that God moves and often lived in nature. The entire universe is god. Nature or God can be interpreted as its own cause and is often self sufficient. Man in his egoistic ways has tried in all ways to imagine that God is like him and that GOD acts in the interest of man at all times. However, according to him, God does not love or hate. The nature of God is different from us and from our dreams and aspirations or interests. Therefore, human beings should stop equating themselves from God because He is infinite and self sufficient. There is no way man can equate themselves to God because God is above everything. He created everything in the universe himself.Question threeIn his theory to be is to be perceived, Berkeley concludes that all that individuals know about an object is only the perception of it. Individuals rarely think or know an object unless it is perceived by the mind. Since individuals are capable of perceiving other human beings in the way that they speak, he can only believe in their existence and in the whole world being identical to every individual. Thus, the assumption is that the world is analyzed with all the five senses and it often impossible to perceive the world without the five senses. We cannot make sense of an object or situation unless we perceive it. This theory was criticized by many due to the fact that he said we can only know an object by perceiving it. Question fourHe did not believe in innate ideas that an individual is born with. He said that our minds are often in a blank state. Experiences through senses and all our reflections filled this slate. He came up with distinction of simple and complex ideas. Simple ideas are those ideas originating from the senses which cannot be broken down. Complex ideas, on the other hand, are a combination of all simple ideas. From these two ideas, one could know the primary and all the secondary qualities of an object. All objects have specific attributes that may fall in either the primary or the secondary qualities. Primary qualities are found in the object and are objective because they are perceived by almost every individual. Secondary qualities are all attributes that the perceiver brings to the object. These are subjective because everyone brings different qualities to the objects. Thus, his theory of representative realism came from all these ideas. The world represents the entire external world but does not necessarily duplicate it. Instead of experiencing the world first hand, we first experience it indirectly via representations.Question fiveLeibniz explained that the world is made of infinity of many simple substances known as the monads which were characteristic of his rationalistic views. Aggregates are built from these simple things which according to him are elements of all true reality. Simple substances were incapable of being created or destroyed. Thus, Leibniz entails that monads are composites which are classified as a collection of simples. These simples cannot be broken down of their constituent parts due to their smaller magnitude thus they are true atoms of nature. This means that they are the main constituents of our universe due to them lacking parts. Due to this, they are the only true identities. These monads must possess certain qualities or they cease to exist. Due to their unique status, they must possess qualities different from other monads.Question sixHume asks us to consider what impression brings about our conception of the self. Human beings tend to perceive themselves as selves- independent and stable entities existing over time. However, no matter how hard we examine our own personal experiences, we do not observe anything that is beyond our feelings, sensations and also our impressions. It is impossible to observe ourselves in a unified way. There is no particular binding that brings our specific impressions together. We can never be aware of ourselves but only aware of our experiences at a certain time. Thus, the self is only a bundle of perceptions. This may be due to our attribution of our existence to a collection of associated parts. This belief is mainly natural with no known logical explanation.Question seven

Hume made an observation that many people acknowledge a conjunction between two events. However, there is no way to establish a connection. This makes him argue against the concept of cause and effect. People assume that one thing causes another, but there is also the possibility that one event does not cause another. He claims that causation is only a question of association which is unfounded and also a meaningless belief. When we experience two events following each other repeatedly, we tend to associate them with cause and effect and this is only logical. The instinctive belief of causality is rooted in our biological concepts such that it is very difficult to erase. By accepting out limitations, we can deal with this situation by functioning without abandoning all our beliefs about cause and effect.Question eightKant achieves the Copernican revolution by turning all his focus of philosophy from metaphysical speculation of the reality nature to critically examining the nature of the thinking and the perceiving mind. He acknowledges that reality is a joint that creates external reality and the human mind. We can only acquire knowledge by regarding the latter. To solve the problem presented by Hume, he rubbishes the idea that the mind is a blank state. The mind not only receives information but also shapes the acquired information. Knowledge is, therefore, not something that is created externally and then introduced into the mind. Rather, it is created by the mind by filtering various sensations using the faculties of our mind. Thus, individuals only grasp knowledge in its general form informing our experiences.Question nineIf Hume’s arguments are true, then science and knowledge have implications in general. This is because science tends to make us believe that events occur in conjunction. Science makes us tend to believe in causation and effect. This can be detrimental to human beings because even in the events where causation and effect relationship does not exist, people will only believe in their existence because science suggests so. On the other hand, knowledge may inhibit an individual from believing in their perception. An individual with a considerable level of knowledge will tend to believe that they are independent entities. This is not right according to Hume because our personal experiences originate from our senses.Question tenTo exist independently means that one is stable alone without the help of others. Individuals do not have necessarily to depend on any other person’s ideas or perceptions. What other people tend to perceive us or say about us does not bother us. Individuals tend to think of themselves in a certain way and that is how they live for the rest of their lives. What other scholars have written or what other individuals close to us say is not put into much consideration. Every individual can operate on their own with what they perceive as right according to their own ethical beliefs.

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Depression and Counselling Theory

Depression, Counselling Theory

Depression and Counselling Theory

Counselling Theory Paper

George is an elderly man, aged 68 years, who showed serious signs of depression and addiction to alcohol and narcotics. He also exhibited signs of being a mentally ill man, who knows his past mistakes in life and sees no reason to even try changing his current situation. He is a divorced man who has little contact with the social world and the only relationship that he currently has is with his dog Spike. I decided on using the Cognitive Behavioral Therapy (CBT), as the most appropriate counselling theory to help him.

Rationale for Selection of CBT

The rationale behind choosing this specific theory is due to the capabilities of the theory and the nature of the case at hand. According to David, 2006 CBT, it is based on the premise that people should learn to let go of their past and focus on improving the future. Central to this therapy is that it focuses on talking. This allows people to express what they feel without fear of judgement (Williams, et al, 2013). According to Blehar, 1997, CBT works also when used with people who have an addiction to something.

George can very well express himself and his life with detail and precision; this is why this therapy best suits him. For a person of his age, he has good memory and is able to remember issues that had happened earlier in his life even under the influence of alcohol. George has serious cognitive impairments; he was able to score 15 in the MMSE test and a 45 out 60 in the CES-D score which is a clear indication of cognitive impairment. George is also an alcoholic, he uses drugs like marijuana and even hard core drugs to help him ease his thoughts and to feel better. George is also willing to corporate with the therapy; this is mainly because he recognizes the fact that his life is not exactly how he wanted it to be at his age. As much as the therapy is not meant to cure the physical ailments and addictions of George, it is meant to create an empowering foundation and a more optimistic way of dealing with his problems. His fear to face the future is hindering him from achieving the best he can in relationships.

Initial Problem Selection

George is a man troubled by many issues but I chose to deal with two of his problems, depression and addiction to alcohol and narcotics. From the interview, it was clear that George’s divorce had taken a toll on him. This was because it made him lose all personal contact that he had maintained earlier on. He has also lost touch with his religion. As a Muslim he was a dedicated follower but all that was lost ten years ago when he started eliminating himself from the society and all types of relationships.

According to Knight, 2006, depression is usually revealed when the individual pulls himself away from the society. This is because they feel that they are better off being alone as nobody wants to be with them. At this point George feels like there is no way his problems can be solved by anybody. This explains the reason as to why he is afraid to patch things up with his ex-wife. At this point he is afraid of starting any form of relationship with anybody and that is why he has had no intimate or friendly relationship with anybody in a long time.

Roth, Pilling and Hill, 2009, state that depression is associated with low self esteem and self criticism. Counselling for depression is a model that targets emotions that mostly are underlying and are the root cause of the depression. It is also meant to bring out the emotions that make sense to the person but must initially come from them for them to be willing to try them out in their lives. Roth, Piling and Hill devised a framework on how to help people with depression called the humanistic framework. It is based on allowing all the negative emotions and issues to come out and then the positive ones will slowly come out. The results of the experiment done at the Pearson Centre proved that people do indeed have the ability of coming up with the best solution for themselves but first they must be given that chance to do it themselves and must be dedicated to it as well.

The framework will work for George because from the interview it was clear he is suffering from clinical melancholy, which is depression couple up together with some cognitive problems.

Discussion of the Model

I will show how the qualifications that make George to fit into this framework.

The framework focuses on a step to step follow up of the individual who experiences different events in his life that ultimately lead to depression while others are as a result of the depression (Scherer, 2009).

First the individual makes a few wrong decisions in their lives. George had always wanted to have the life that everybody wants, a nice job and a lovely family. But somewhere down the line he made some few mistakes that caused him to lose some of these things and he now sees his mistakes.

The next step is that the person is caught up in looking at his mistakes instead of finding clear solutions to them. Instead of focusing more on what he still had even after making his small and major mistakes, he focused on the mistakes. This is evident from the fact that after he divorced his wife he completely cut all contact and relationship with everybody else. After his divorce, he saw no need of going to mosque and with that he lost a relationship with his God. He also let his relationship with his mother be reduced to an occasional phone call. His relationship with his brother is no longer the same and the one with his daughters is even worse. This cannot even describe the relationship with his friends because i is no longer in existence, he believes that they avoid him since he has his problems.

The third step is that the persons self esteem is seriously affected and they criticize themselves very harshly. George’s self esteem was seriously affected; this is the reason why on looking at him during the interview he looked unkempt. His uniform was dirty and he was not shaven. Hours after his shift ended he is still in his uniform while most people cannot wait to leave work and take off their uniform. This is because he sees no need to do that, to him it is not worth the trouble. He also believes that nobody wants to be associated with him, according to him he is not the one who pulled away from his friends, they are the ones who avoid him because they believe that he is mentally unstable. He is even not sure about reconciling with his ex-wife and it is not because he does not love her and does not long to have some company but it is because he feels he has failed her too much in the past and he doesn’t deserve her taking him back. He feels like he is failure and does not deserve to have someone with him.

The last step is when the person takes up a destructive addiction or activity that helps him escape from the world and feel better for just a while. The other step was George turning to alcohol and drugs and becoming addicted to them. He consumes alcohol because he believes it is the only way he can relieve himself of the stressful issues that he has. To him, there is realistically no way of solving as it is too late. Time has passed too much and there is not much that can be done. Once he uses these drugs and consumes alcohol he goes to another world where he gets the chance to get away from all the worries.

At the heart of the model is the interaction of emotions that lead to some cognitive and behavioural attributes;

Lacks of paying attention to the small things in life, for instance most people do not brush their teeth nor shave their beard. This is the behavioural character that is very visible on George. People also forget the day of the week, George can hardly remember the date and avoids doing any calculation on the test and does not write much on the questionnaire. This is because he probably finds it difficult to do simple addition and subtraction. This means that he is not interested in the events and occurrences of the country for instance politics, economics and even security matters. To him they are of less concern and there is no need to get to know them.

Poor communication skills are exhibited; this is because the people feel like others cannot understand them when they speak calmly. They may feel the need to act it out when trying to explain a specific point. This is reason as to why George feels the need to throw his arms out while speaking. This is because in his mind, he thinks that what he is saying will not be understood unless he actually demonstrates it using hands.

Denial is also a major emotional and cognitive defence mechanism. This is exhibited by tendency not to admit to some situations (Scherer, 2009). During the interview, George also skips over things that he does not feel like talking about. This means that his problem is actually bigger than he is willing to agree. The fact that he believes that he only drinks because he is lonely at times and not because he is an addict is also another point of denial.

Implications for Treatment

The treatment will be done in three phases the early, middle and final stage. This will be done in roughly 15- 20 sessions with George. At the end of the treatment there will be certain expected results and changes.

According to Williams, et al, 2013, the move to another stage will only be possible after the successful completion of the previous stage. The early stage is made up of discussion with George on the strategy to be used, to collect the necessary data required and all relevant information. It is in this stage that George gets to reveal his expectations at the end of the sessions and after several months after the sessions as well.

After that we shall move on to the second stage, at this point there will be several experiments performed to see if the strategy and the framework completely fits his situation, several adjustments can be made to ensure that the strategy is efficient (Blehar, 1997). It is also at this stage that we deal with George’s emotions, as stated earlier he will let all the negative emotions come out and with little assistance he will come up with a suitable and realistic solution that can solve his depression, fears and help mend his relationships. In the final stage, there will be the termination of the sessions and also the implementation of a strategy that will avoid relapse into depression and alcoholism.

During the first stage, all information and data pertaining George will be revealed. This is because the information in this stage will be used in the next stage. George is expected to grasp the seriousness and conceptualize the CBT and all the expectations from him. All the pre existing issues from his decision to leave the basketball sponsorship will be addressed and will act as a foundation in his case.

In the second stage George will bring out all the negative emotions, what he actually and truly feels so that it can lead him to alcohol and to shut himself away from the rest of the world (Blehar, 1997). All the broken relationships will be discussed and the various ways in which they can be amended. It is obvious that George knows some of his mistakes but what he does not seem to know is how to solve them especially at this time when he has grown old. As a father, a son, a brother and a friend he has a role to play in these relationship. He has to come up with the solutions but a relationship at a time to avoid overwhelming him. Having closure is something important in any relationship, it may not mend it but it will help one not to carry emotional baggage.

In this stage George will explain how his life was like before all the changes and which aspects were there and he would like to have back. He will experiment by trying out some of the interests that he had prior to adopting the alcohol drinking habit. It is also at this point that all the negative side effects of his current life will be made to him; however he has to be the one to point out what exactly he feels he is ready to start changing. This will give him the chance to voluntarily give out information.

In the final stage, as the sessions are terminated there will be strategy that will be aimed at ensuring that George will have a social life that includes at least taking spike for a walk in the park full of people and trying out the outside world with his new friend and see if he can make new friends. George is expected to create a new habit that takes the place of drinking alcohol, for instance playing a sport or even reading a book. Then termination will occur with follow up to take place periodically.

Further Discussion

Although this paper is basically supposed to be dedicated to George and his psychological issue of depression, it is also going to dedicate on a few other issues that George is going through and how to best resolve them. These are issues that can be solved by CBT and others cannot be solved by it. It is limited to the psychological aspect of George.

At the age of 68 years George is still physically able to provide for himself but with time he will retire and will be dependent on other people. this is the high time that he solves the issues to do with his mother and daughters before it gets to the point that he completely has no other alternative.

George has cognitive impairment that requires to be treated. This is evident from his lack of coordination of the issues during the interview. This can be as a result of alcohol consumption over the years. This is because alcohol with time decreases proper mental and physical coordination. This may be the reason as to why his hygiene is questionable. Medical intervention is required as there be other physical negative effects that he has developed over the years and during the interview I was not able to detect. For a proper evaluation, a full body check up should be embarked on.

Due to years of withdrawing from the social world, he may be willing to go out there to make friends but may not know how to. He may require a few sessions to be conducted outside in the open where there is interaction with people. This being a person who is looking to stop alcohol intake and is looking for a new hobby, a visit to a golf court would be highly recommended. This however easily follows during the follow up sessions.

Conclusion

George has gone through many traumatic and tough times and he is only human to feel stressed. However he feels judged and this has made him to shrink further and further away from the society. At this point his ex wife is trying to reach out to him but he is way too deep and sees just a failure who will fail her again.

George dedication to the process and strategy will help him to be able to restore his life to the way it was if not better, but he still requires all the other to be willing to help in this process as well. This is because someone may dig themselves into a hole that gets too deep. But when at low place the only other place to go is up and this is his situation. He is willing to come up but he just needs the people around him to help dig his way out.

With a little help from his family and friends George will be able to solve all his psychological problems and become a well off productive citizen.

References

Cognitive-Behavioral Interventions With Older Adults: Integrating Clinical and Gerontological Research, Derek D. Satre, Bob G. Knight, and Steven David, 2006, Professional Psychology: Research and Practice, Vol. 37, No. 5, p 489-498

Psychotherapy for Depression in Older Adults, Edited by Sara H. Qualls and Bob G. Knight, 2006, Wiley Series in Clinical Geropsychology

Counselling for Depression; Critical look at Cognition, Roth, Pilling and Hill, (2009), Pearson Print Press

The Psychological Treatment of Depression, J. Mark, G. Williams, 2013, University of Oklahoma Print Press, p324-455

The cognitive Psychology of Depression at Old Age, Ian H. Gotlib, Howard S.Kurtzman, Mary C. Blehar, 1997, p 94- 150

Self stigma and Psychological Depression; Help Seeking for Depression, Joshua Scherer, 2009, p 7-56.

Derive. My companion and I set off in a random direction and walked down the commercial street.

Derive. My companion and I set off in a random direction and walked down the commercial street.

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Derive

My companion and I set off in a random direction and walked down the commercial street. The street was busy and the air smelled stuffy. These activities reminded me of the times when I used to work in the mall. I felt quite uncomfortable especially when I saw a White lady shouting at a young Asian lady to stop staring at the passers by and concentrate on serving the clients. We entered the mall and the smells we encountered were of new clothes. These were being unpacked and put on the shelves. The respective smells reminded me of the days when I was young. My mother used to take me shopping and would buy me almost everything that I wanted. This feeling became better when we passed by a cosmetic shop and smelled my mother’s cologne. For a moment, I felt that I was in company of my mother and relaxed a bit.

We then proceeded to the central park where we met so many people resting on benches. Most of them looked tired because of the hot and humid weather. We spoke to a young African American lady who looked a little bit frustrated. She informed that her mother had just passed on she was feeling a little bit distressed. The park was well kept and had litter bins in almost all places. Landscaping was also well done and the place generally looked beautiful. This heightened our emotions a bit and we proceeded to the next commercial building. The building was filled with the smell of disinfectant. It was already five o’clock and since most of the occupants were leaving, it was being cleaned. This smell reminded me of a hospital environment. Only that in the later, the smell of disinfectant was mixed with that of medicine. The cleaner that we spoke to told us that he was not satisfied with this work because it always made him feel sick.

Reflection

At this point, it is certain that my previous personal experience greatly influenced my perception of space. Notably, when I entered the mal, I assumed that the place is crowded and very busy because previously, I worked in a mall under similar circumstances. This made me to feel very tired and considered the place to be unworthy of exploring further. Notably, the smell of disinfectant made me to remember the hospital because I had smelled the respective disinfectant in the hospital. This made me to make certain presumptions about the cleaner regarding his lack of satisfaction with his profession. This turned out to be true as the cleaner affirmed that his work made him to feel sick.

To a great extent, my racial and gender beliefs influenced the decisions that we made with regards to interviewing certain individuals. In the mall, I only saw an Asian lady being shouted at by her boss and not a White lady. In addition, I only say an African American woman in the park feeling distressed and decided to interview her. This does not imply that there were no White men in the park looking tired or frustrated. My racial and gender beliefs made me to consider the abovementioned individuals to be requiring more attention and to possibly be more troubled than the later. The relief that I felt after smelling my mother’s cologne can also be attributed to the relationship that I share with her. Whenever I think of her or come in contact with anything that reminds me of her, I feel comfortable and safe.

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Deregulation And Globalization

Deregulation And Globalization

Deregulation And Globalization

International business refers to all forms of business operations linking different countries. This works over wide geographical regions. However, for there to be a smooth process in the operation of the same, countries involved always have to come up with decisions and agreements on how it has to be operated. Ball, Don, et al (2009) state that for there to be binding agreements between various players in business alliances, all parties have to be satisfied. If not the mergers will definitely fail. Normally, such accords act as impediments to the operation of the international business if certain parts curtail the rights of partners’ involved. An insight into the nature of international business gives experts an avenue to ameliorating the loopholes that constantly emerge. I choose to deal with matters regarding international business as they regulate all forms of business entities in the entire world. The process of regulating the nature of operations of international business provides a daunting task for business corporations to easily and profitably exist. In this line therefore, I seek to analyze the situations in the air transportation with relation to how it contributes to the operations of the international business.

Research documented by Dr. Zhi. H. Wang (2004) actually shows the existing differences in the process of liberalizing air transport in various demographic regions. This liberalization has had a direct market change for the players involved in air transportation. It is the actual reason for the creation of most strategic mergers between various airline companies. Such mergers and deregulation have had an impact in the globalization of air transportation and should thus be carried out hand in hand. They have resulted in the sustainable growth of the individual countries, economic situations as well as the well being of the individuals travelling. Obstacles that existed before in air transport sector such as issues to do with deregulation have thus been done away with. Wang holds the view that the multifaceted nature existing in international business setting today comes from a variety of reasons which occasion long term challenges. It is such challenges that continue to affect the procedures and basic advances towards globalization.

In this measure therefore, I seek to delve into this challenging environment that presumably is the major discerning issue in international air transport system. The experiences of September 11 cannot be easily forgotten. The abduction of aircrafts for use in terrorist attacks caused a major upset in the transport sector. Consequently, a remarkable decrease in passengers also occurred. Apart from this, other major troubles sprung up including new regulatory directives, inability for some companies to source additional funding, and an unprecedented rise in jet oil prices. These situations were further worsened by the halting of various airline operations and the rescheduling of certain deliveries by the aircrafts. According to Philling (2001) all efforts aimed at attracting back passengers has caused a continuing reduction in airfare sometimes creating losses.

One might therefore ask why many airline companies agreed on having alliances. The answer to this lies in the fact that as long as wars about prices are waged amid financial problems, economic recessions, terrorism, and even competition from each other, there will always be losses to contend with. I strongly support the idea that the best way to stop this is in the formation of mergers in order to sustainably profit from this venture. Airline mergers have been in effect since the 1990s. Alliances have also been as a result of countries seeking to tap into the basic incentives that come with membership. This is facilitated as a matter of fact by the signing of major airline accords by the various nations that enter into such agreements. A historical fact suggests that most international corporations have been wary of venturing into this airline business due to the regulations on alien equity ownership and entry by foreign players into domestic routes (Staniland, 1997).

In the face of these very difficult scenarios, most international operators find it appealing to enter into such partnerships so as to gain entry into fresh market and offer certain services (Oum, Park, & Zhang, 2000). In my view therefore, it is very imperative that a combination of deregulation and liberalization of the airline transport be sought since they effectively support each other. The issue of liberalization still continues to be of concern since it promotes globalization which may lead to a number of problems as much as it results in sustainable development and improvement in the living standards of the people.

There is documented evidence about the progress of the liberalization process from periods in between 1978 to 2003. In 1978, the United States decided to deregulate its transportation system so as to free up on the markets (IATCA, 1979). This act leveled the playing field for the other entrants into the market through the start of various policies that were friendlier. Later on a number of mutual agreements were undertaken that led to a number of operational airlines being formed. In March, 1992, there were agreements that saw the opening up of the skies. This was spearheaded by the United States. While it existed, the United States was better able to have its air carriers explore many other forms of liberalized market segments of the entire globe. One among the very first of such documented accords was between the Netherlands and the United States. It was carried out in September 1992. Basing from the above activities that occurred in the said years, I strongly hold the view that it is these mergers that were the precursors towards various forms of relationships such as IT, ground handling and sales of many products.

I strongly agree with the assertion that deregulation brought the sanity that was missing in international business. It opened up closed markets and led to a further improvement in the market effectiveness. When it was introduced it came in three segments. The first segment that started in January, 1988 permitted all the companies involved to increase their capacity in the routes that they practiced. They would also get entry into certain markets and also to dictate on the fares that were to be paid on the routes. The following package saw to it that all regulations that had been put upon airports removed. It also lessened the nature of the mutual contracts that existed then. The final package was put in place on June 1991. All this packages were the ones that were essential in the blockage of any form of discrimination against any particular airline based on forms of nationality or other discrimination (Shon, 2003). It was a plus in the direction towards the opening up of the international markets. This further boosted the economic situations of the countries that were involved.

It is only fair that I also look into the advantages that have been necessitated by the liberalization of the air passenger services. This is so because the number of air flights remarkably sky rocketed, the market dominance and shares, city pairs and an increase into the number of air carriers. This provided a right step into the right direction. The actual removal of the barriers of entry into this industry further created a conducive environment for other competitors in the industry. This therefore means that as we endeavor to free up the markets for international operations, the required conditions for the operations of the airlines is also effectively facilitated. This goes a long way in the development of not only the airliners but also the individual countries involved in these mergers. It also enables all the multi national companies to have a fair playing field with their competitors in the field.

To those concerned with the operations of the international market, liberalized markets and deregulation provide quite a good environment for businesses to prosper. Entrepreneurs and international managers can thus take advantage of the windows of opportunities existing to set up quite successful business enterprises. Currently, several individuals have taken advantage of this situation and have set up quite successful ventures in air transport. Such an entrepreneur is Sir Richard Branson whose virgin Atlantic airliners operate quite competitively with the other major players.

In conclusion therefore, a study into the air industry in the U.S suggests that small sizes of functions tend to prosper. However, I disagree with those that are of the view that international markets cannot pose a risk for the operation of the various airlines. This is because the opening up of these markets encourages other forms of activities such as terrorism and other economical wars between countries. However, the focus in the markets and the step by step development of the world markets could be the only remedy in dealing with the quite an unsteady and doubtful situations into the future. The opening up of free markets and the strategic mergers have participated in a major way in the growth of economies, protection and dynamism. However, although this view that globalization has various benefits, it is also very true that other challenges are created as a result.

References

IATCA. (1979). International air transport competition act of 1979. United States, PublicLaw.

Oum, T. H., Park, J. H. & Zhang, A. (2000). Globalization and strategic alliances: the case ofthe airline industry. Pergamon: Elsevier Science.

Philling, M. (2001). Crisis action, airline business. Cambridge: Cambridge University Press.

Staniland,M. (1997). Surviving the single market, corporate dilemmas and strategies ofEuropean airlines. London: St Lucie’s Press.

Shon, Z. (2003). The study of airline merger. New York: Jalic Inc.

Zhi, H. (2004). Deregulation and globalization: process, effects and future challenges to airtransport. Cambridge: Cambridge University Press.

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Depression in Patients after Cerebral Vascular Accident

Depression in Patients after Cerebral Vascular Accident

Depression in Patients after Cerebral Vascular Accident

Introduction

Cerebral vascular accident (CVA) is the abrupt disruption in brain function due to disturbance in the cerebral blood supply (Warlow, 2007). A third of these patients eventually develop depression. Depression is a mood disorder which significantly impairs the psychosocial functioning of a person, and further leads to somatic symptoms. Such depression is also known as post stroke depression (PSD) (Warlow, 2007). Therefore, it is imperative to identify aspects pertaining to this disorder that will help in according the best cure or prevention. In order to do these, this paper seeks to explore the topic of depression in post stroke patients by utilization of critically appraised articles and past literature.

Background

Stroke is identified as the third leading cause of death and the most devastating and disabling disease. It has devastating emotional impact on the patient, family and society. According to Schwartz, Speed and Brunberg (2001), about 30% of the patients diagnosed with stroke develop depression within their lifetime. Following stroke, depression is often persistent and severe interfering with the rehabilitation process of the patient. The exact etiology of post stroke depression has not been identified. However, this type of depression is responsive to treatment.

Various research studies have been conducted seeking to identify the factors contributing to post-stroke depression. Advancements in technology have enhanced neuropsychiatric studies in understanding post-stroke depression. According to Astrom, Adolfsson & Asplund (2003), age and socio-economic status of the patient play no role in the development of post-stroke depression. Poor social function of the patient following stroke results from the depression rather than a cause of it. Astrom , Adolfsson & Asplund (2003) argue that the degree of disability following stroke is related to the development of depression. Previous social functioning, personality and mood disturbance play a crucial role in the development of post-stroke depression. Alcoholism and drug abuse before the stroke also contribute to the development of post-stroke depression.

Literature suggests a relation between the location and size of lesion after stroke and depression. Large, anterior lesions located in the left cerebral hemisphere have been shown to be associated with post-stroke depression. A study conducted by Herman (2001) revealed that post-stroke depression may be attributed to biochemical derangement. In the study, depressive stroke patients exhibited abnormalities in the neurotransmitter concentration, alteration of the sensitivity of the cortical receptor and derangement of the electrophysiological parameters. In addition, these patients have decreased cerebral blood flow.

Robinson (2003) highlighted that higher incidence of post-stroke depression are seen in patients with left hemisphere lesions. According to the author, the severity of depression is related to the distance between the anterior pole of the left hemisphere and the location of the distance. Literature also suggests that lesions located on the basal ganglia and left frontal lobe are linked with severe post-stroke depressive disease. In addition, lesions located in the left hemisphere basal ganglia play a vital role in the development of major depressive disease following acute stage of stroke.

According to the biological theory, children who are genetically predisposed to depression and suffer loss at an early age experience alteration of the biochemical state resulting in depression. According to this theory, family genetics and environment at an early age play a crucial role in developing depression during one’s lifetime. In the cognitive behavioral theory, depression results from low self esteem. Literature on the transactional theory reveals that depression results from interaction between the society and environment (Wade, Legh-Smith and Hewer, 1997). Certain disruptive changes, for example, family disruption and drug abuse, in the society and environment predispose an individual to depression. Stressful events, for example, separation at an early age, have been implicated as antecedents or precipitants of depression.

Post-stroke depression is associated with poor clinical outcome. This is because depression interferes with the recovery and rehabilitation process of the patient following stroke. The patient is not able to improve or maintain improvement following intensive rehabilitation if they are depressed. Clinically important results of post-stroke depression were found to be poor long term functional recovery, reduced social functioning, social contacts and quality of life (Lishman, 2008). This significantly interferes with the prognosis of the patient following stroke. Therefore, it is crucial to manage depression before engaging the patient in intensive rehabilitation.

Literature Review

3.1 Search Methodology

Inclusion Criteria

The articles included in this study are journal publications between 1st January 2002 and 2012. This particular data was chosen as it would reflect the current state of technology and not rely on outdated research (Vishweshwars, 2000). There were several databases used including Medline, CINAHL (EBSCO Host), BMJ, E-Journal, MEDLINE and PsyArticle and the Cochrane Library.

The studies included research on both males and females, and the type of papers that were included were clinical trials, meta-analysis and randomized control trials. Data was included from adult patients who developed stroke after the age of 18 years onwards. In the beginning of the review, 12 studies were obtained but, after reading through the abstract only 5 articles were found to be related to the topic. 7 articles hand searched were also included as they were relevant to the topic area. Altogether 12 articles were in included and appraised . Majority of the articles included in the study focused on the management of patients with depression following CVA.

The qualitative studies reviewed in this research included Vickerey (2008), Hackett (2010), Schonberger (2006), Williamson (2011), Tang (2011) and Yi (2010). Vickerey (2008) focused on the relationship between self-esteem and recovery in stroke patients while Hackett (2010) discussed the development of negative cognition in stroke patients. Schonberger (2006) described the relationship between stroke brain injury and various parameters of patient compliance during stroke rehabilitation. On the other hand, Williamson (2011) elaborated on validating various tests in patients with acute stroke to identify neglect. Tang (2011) demonstrated the link between cerebral micro bleeds and development of post-stroke depression. Yi (2010) described the assessment of the anti-depressant flouxetine in the management of PSD.

The quantitative studies included Kim (2012), Fatoye (2009), Buijck (2012), Tsai (2011), Schmid (2012) and Mikami (2011). These studies were conducted to demonstrate the quantitative parameters of evidence including higher incidence of depression in stroke at a community level (Kim, 2012), greater incidence of PSD in poor nations (Fatoye, 2009), the presence of a greater number of neuropsychiatric symptoms in elderly patients following stroke (Buijck, 2012), importance of social role functioning in the rehabilitation of PSD (Schmid 2012), and the prevalence of PSD following treatment with antidepressants (Mikami , 2011).

Exclusion Criteria

These included books, non-medical journals, journal reviews, letters, comments and clinical practice guidelines. In addition, articles that focused on depression in children following CVA were excluded from the study. Further, articles that did not provide clear scientific methodological approaches were excluded from the study.

3.2Qualitative Studies ——you don’t have to put this as a sub heading . you need to just mention that the study is a qualitative as you appraise the paper .

All studies used appropriate tools to collect and analyse the data as per the study designs. Vickery (2008) elaborated on the relationship between self-esteem and functional recovery in patients with acute stroke by conducting a bivariate correlational analysis and multivariate regression analysis on the functional status and self-esteem of patients with depressive symptoms. The research methodology utilized in the study was appropriate.what is the rationale of using appropariate method with textbook reference . The survey was conducted in an acute in-patient rehabilitation hospital which was appropriate for the study. The researchers recruited 176 participants for the research. This sample size is sufficient to give reliable results that can be used to demonstrate on the general population what is the rationale of using appropariate sample size with textbook reference .. However, information generated from this sample population can only be applied in patients who have suffered an acute CVA attack. The analysis method used in the survey was adequate and appropriate to produce reliable results. The authors concluded that self-esteem ratings may have a moderating role in the relationship between emotional outcome and function. The information generated from this survey can be used for future studies. However, the authors did not consider the potential biasness resulting from the relationship between the participants and surveyor.

Hackett (2010) conducted a prospective, hospital based cohort study that sought to find out whether significant negative cognition measures were missed in conventional approaches used for screening patients with acute stroke for depression. The methodology and analysis technique utilized by the researchers was appropriate for the study what is the rationale of using appropariate method with textbook reference . However, the sample size recruited for the study was not adequate to generate results that can be reproduced on the general population. In addition, the follow-up period for the study generated inconsistencies as a majority of the patients recruited in the initial study did not return to the hospital for follow-up results.

Schonberger (2006) used tools such as WAI, EBIQ, awareness and compliance levels to collect data, and prospective tools to analyse the data. The methodology used was appropriate for the study. However, the sample size was not adequate to generate results that reflect the general population. In addition, the analysis techniques used was adequate to address the hypothesis of the study. The information generated in this study is reliable and can be applied in future studies.

Williamson (2011) reported on the validation and functional correlation of patients in chronic and acute stroke using Apple’s Test. The study was conducted in three stages seeking the functional and validation correlation of patients diagnosed with acute and chronic stroke. The methodology was extensive generating complex data that address the purpose of the study. The analysis procedure was adequate and information generated from the study is reliable. However, the sample size used in the study is not adequate to generate results that can be practical for the general population. In addition, the methodology used in this study generated complex and cumbersome results, which served as a source of limitation when analyzing the results.

Tang (2011) examines the relationship between cerebral microbleeds and post-stroke depression. The methodology and analysis used in the study was appropriate. The research setting and population size was adequate to generate reliable results. The use of an MRI to confirm the diagnosis of cerebral microbleeds and structural brain changes resulting in post-stroke depression is appropriate for this study as the findings are scientific based. However, the relationship between the researcher and patients during the follow-up period introduced potential bias in the study results.

Yi (2010) collected data using relevant information from the literature reviews on fluoxetine. Statistical tools like odds ratio and weighed mean difference were used to analyse the data. The literature review adequately addressed the research questions for the study. In addition, the methodology and analysis method employed by the researchers was appropriate for the study. The sample population was adequate to generate reliable information that can be applied in the general population.

3.3 Quantitative Studies

Kim (2012) used the data collection tools CESD (Centre for Epidemiology Studies – Depression including the components Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA)), and Mini-mental state Examination (Korean Version). For the analysis, he used SPSS 17.0 and AMOS 7.0, for CFA, EFA, and internal consistency of Cronbach’s alpha. Kim (2012) had a sample size of 203 patients undergoing stroke rehabilitation in primary care settings, in Korea. This was nearly similar to the 118 patients who were undergoing rehabilitation in a Nigerian Teaching Hospital demonstrated in Fatoye (2009). The results of Kim (2012) study suggested that CESD scale is an imperative tool when it comes to screening for depressive symptoms. Comprehending the psychometric properties of the CESD scale would help health professionals in the assessment of community-residing stroke patients.

Fatoye (2009) used Beck’s Depression Inventory and the Mini-mental state examination (MMSE) to collect data, and statistical methods used to analyse the data. The method employed to conduct the study was a clinical trial of comparing cases with controls, and was relevant as it involved comparing cases with controls in a third-world nation (Nigeria). The results were that there were three variables that had a significant correlation with depressive symptoms. This included low education, paresis and cognitive impairment. Post stroke depression patients with any of these variables had higher symptoms.

Buijck (2012) undertook a study to determine that course and prevalence of neuropsychiatric symptoms in post-stroke elderly patients admitted to rehabilitation facilities. It was a longitudinal multicenter study (involved 15 facilities). The author studied the neuropsychiatric symptoms in elderly patients that were admitted to skilled nursing facilities (across the Netherlands). The author used a sample size of 145. Data was collected using the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) at admission, and compared with discharge. Data was analyzed using statistical methods. The findings of the survey revealed that the overall prevalence of Neuropsychiatric symptoms was lower than that reported by other studies. The findings of this study suggest that neuropsychiatric symptoms should be optimally managed so as to improve the rehabilitation outcome.

Mikami (2011) was a clinical drug trial involving comparison of a case with a control in an RCT setting. Treatment with antidepressant (escitalopram, an SSRI), psychotherapy (Problem-solving therapy/PST) and a placebo were studied. Data was collected using DSM-IV-TR and HRDS, and analysed using Kruskal-Wallis test (for continuous variables), along with Fisher’s extract test (for categorical variables). In the findings, Hamilton Depression scores and new onset major depression scores were increased 6 months after drug discontinuation, compared to the PST or placebo group. Therefore, antidepressants have an imperative role in decreasing post-stroke depressive symptoms.

Tsai (2011) was a double-blind randomized placebo-controlled trial, and like Mikami it was also relevant as it included studying a drug (milnacipran in patients with acute ischemic stroke) with placebo. Data was collected based on the DSM-IV-TR tool at frequent intervals (0, 1, 3, 6,9,12 months) (for identifying the signs of depression) and analysis done using appropriate statistical methods. DSM-IV-TR in both the drug trials was used as a tool to determine the presence of depression in post-stroke patients. Mikami and Tsai were both drug trials that compared an antidepressant to a placebo and other forms of treatment. The sample size of both the studies was similar (108 and 92 respectively). Tsai found out that Milnacipran had a significant role in preventing the development of Post-stroke depression. Therefore, the drug might prevent the development of depression within one year after stroke.

Schmid (2012) undertook a quantitative study to determine the role of social role functioning in the development of depression in post-stroke patients. This study was a cohort study, and data was collected using interventions such as phone calls for Patient Health Questionnaire Version 9 (PHQ9), which was ideal to complete information on the questionnaire. The social section of Stroke-Specific Quality of Life Scale tool was used to determine social role functioning. Schmid (2012) study had the highest sample size number with 372. Comorbidities and depression were found to have an independent association with a twelve week social role functioning. Therefore, improvement in social-role-functioning leads to depression improvement. It is important for rehabilitation providers to screen for and manage post-stroke depression.

All studies involved obtaining an appropriate sample, as the studies were conducted on patients with stroke and were undergoing or were supposed to be undergoing stroke rehabilitation. The duration of the studies were also appropriate as it would take PSD the same duration of time to develop as noted in the quantitative studies mentioned.

4.0 Themes in the Literature Review Articles

Several major themes were recurrent in these articles. These include: risk factors for depression and stress after stroke; symptoms and diagnosis of depression in cerebral vascular accidents (CVA); self-esteem and depression in CVA; therapeutic working alliance and antidepressant use in these patients; functional outcome and recovery; and lesion location after stroke in determining depression.

4.1 Risk factors for Post Stroke Depression

Previous history of depression is also noted as a strong precursor for the development of stroke by Miller and McCrone (2005). However, Burvill et al. (2005) study disputes some of these factors as being risk factors for depression development in these patients. These factors include sex, age and severity of stroke.

According to the findings of a study by Fatoye et al. (2009), the rates of post stroke depression are similar in African and western society. From this finding, it is possible to draw a conclusion that race or ethnicity may lack a significant role in influencing the development of depression following a stroke. However, it is imperative to note that cerebral vascular accidents are more common in African Americans than in Caucasians. Therefore, the overall ratio of patients with depression after a stroke may be higher in this group.

4.2 Self esteem and depression following acute stroke

According to Vickery et al (2008), self esteem is associated with individual functioning status following acute stroke. Following stroke, patients tend to have low self esteem because of their inability to perform various tasks. Anson and Ponsford (2006) suggest that self esteem acts as a mediator of improved psychosocial functioning and quality of life by allowing individual to adjust to stressful conditions. On the other hand, Schroevers et al. (2003), argues that self esteem is a personal attribute that buffers individuals against negative effects resulting from stressful events in life.

Vickery et al. (2008) also demonstrated a direct relationship between self esteem, depression and treatment outcome. According to the authors, self esteem acts as a modulator that moderates the effects of depression in patients undergoing intensive rehabilitation following stroke. The exploratory analysis conducted by the authors suggests that self esteem ratings facilitate the relationship between individual report on depression and functional outcome following discharge. On the other hand, Fatoye et al. (2009) relates depressive symptoms to lower education levels, age, motor and cognitive disabilities of the patient following acute stroke.

Vickery et al (2008) clearly elaborated on the effect of low self esteem on the functional recovery of the patient. Fatoye (2009) argues that decreased functioning of the stroke survivors is negatively influenced by the cognitive and motor deficits of the patient following rehabilitation. Both articles agree that depression in the post-stroke patient negatively influences the overall functioning status of the patient.

4.3 Symptoms and Diagnosis of Post-Stroke Depression by the Therapist

There are various studies, which show that primary care givers in the health sector under-diagnose depression, in up to 50% of patients (Kim et al., 2012). This is supported by a randomized controlled trial carried out by Williamson et al. (2011). According to Kim (2011), problems in the diagnosis of depression in the primary care setup arise because not many patients present with clearly identifiable symptoms and signs of depression. This means that some of these patients fail to reach the diagnostic criteria threshold for major depressive disorder. Problems may also arise because the patients fail to accept the diagnosis or when the patient has much mental comorbidity that competes for the attention of the clinician (Klinksman, 2005).

Tools such as Centre for Epidemiology Studies – Depression (CESD) are imperative in the assessment of Post-Stroke Depression (Kim et al., 2011). This will enable early initiation of appropriate management (Schmid et al., 2012). Depression symptoms according to Miller and McCrone (2005), with decreasing order of frequency, include: depressed mood; fatigue or loss of energy; insomnia or hypersomnia; alteration in appetite; diminished interest in activities; suicidal ideations; and decreased concentration. This is relevant to the scope of this paper in that it helps the primary care giver, including the nurse, in identifying patients with depression. Other symptoms that have been noted include feeling guilty, worthless or hopeless.

4.4 Lesion location and depression after stroke

According to Schonberger et al (2006) study, patients with right hemispheric lesions were more predisposed to developing depressive symptoms after six months. There was no notable discrepancy in the severity of depression in relation to anterior and posterior lesions. However, right hemispheric lesions were associated with major depressive syndromes. Unlike depth of the lesion, the size of the lesion directly correlated with the severity of depression. Patients with right anterior lesions reported a higher incidence of emotionalism than patients with lesions at other regions. Vickery et al (2008) and Fatoye et al (2009), relates low self esteem to emotionalism that is characteristic in patients with depression following acute stroke. Tang (2011) related geriatric cerebral microbleed resulting in stroke to depression. The MRI changes following cerebral microbleeds resulted in focal lesions that affected the functional outcome and neurological functioning of the patient.

4.5 Therapeutic Working Alliances

In providing treatment for those with depression after cerebral vascular accidents, it is imperative for the health providers to work in synchrony in affording the patient with the best care possible. In their retrospective case control study, Miller and McCrone (2005) note that mental health clinicians agree with primary care givers in the diagnosis of depression in 66-76% of the time. This shows that primary care givers have the skills needed in identifying depressed patients. Hackett (2010) noted that significant negative cognitions may be missed when post-stroke patients are screened for depression. It is thus imperative to include a sensitive exploration technique on the psychological effects of stroke in the patients so as to determine whether they are at risk of developing depression. Williamson (2011) recommended the application of Apple’s Test in predicting the functional outcome of the patient. The functional outcome of the patient plays a significant role in determining the development of depression following CVA.

Shmid et al., (2012) noted that of the best care that a patient with depression can be afforded with. Patients who were treated for depression in primary care setting with the collaboration of the psychiatric unit experienced better outcomes. In order to increase the therapeutic efficacy in treatment of depression, it is imperative for physicians to be alert to the most essential aspects of post stroke depression. Therapeutic collaboration is imperative in proper management of these patients (Schmid et al., 2012). In a randomized control study by Fatoye et al. (2009), physicians who were aware of depressive symptoms and associated factors of post stroke depression had better outcomes in affording a cure for their patients. Treatment of this condition leads to quality of life improvement among this group of patients.

4.6 Antidepressant treatment of patients with CVA

Post-stroke depression significantly affects the cognitive functions and motivation of the patient to engage in the treatment process. Vickery et al (2008) acknowledged that depression in stroke patients interferes with the patient’s ability to improve and maintain improvement following intensive rehabilitation. Tsai (2011) attributes poor functioning recovery to inability to cope with rehabilitation challenges in post-stroke depressed patients.

Miller (2005) argues that antidepressants are effective in countering the depressive symptoms associated with negative effects on the rehabilitation process. According to Mikami (2011) early detection and treatment of depression significantly contributes to the patient’s ability of full recovery. Drugs such as escitopram are imperative in decreasing the symptoms of post-stroke depression (Mikami, 2011). Yi (2010) highlighted that flouxetine is effective in preventing post-stroke depression in patients who are at risk. However, Fatoye (2009) urged that improvement of the cognitive and motor functioning of the patient influenced the functioning recovery of the patient. According to Fatoye (2009), antidepressant drugs were not necessary in the rehabilitation process of post-stroke depressive patients.

5. Discussion

The incidence of depression following stroke is clearly higher especially between 6 months and 24 months following the stroke episode. The exact cause for the development of depression following stroke may be difficult to determine, though in general, it may be multi-factorial in origin. Some of the factors that are responsible for the condition include biological factors, familial factors, social factors among others. Biologically, depression may be associated with biochemical changes in the brain. During stroke, certain focal areas of the brain are involved, and this may also be responsible for the development of depression. Tang (2011) demonstrated that the cerebral micro vascular bleeds noted through MRI scans, was closely associated with the development of depression. MRI Scans are also useful in a variety of neurological disorders to identify the presence of lesions in the CNS (Hamdy, 2011). In the developing world, some of the associated factors of depression in post-stroke patients include cognitive problems, low education levels and paresis (Fatoye, 2009).

Anderson et al. (2004) reported from 12 trials involving 1200 subjects that antidepressants did not have a prophylactic effect compared to a placebo. However, PST was found to have a positive impact and needs to be pursued by long-term and large studies. The finding of the inefficiency of antidepressants also needs to be substantiated from long-term and larger studies. Tsai et al (2011) noted that antidepressant therapy administered prophylactically at an earlier date (one month compared to the third month), had a better functional outcome in post-stroke patients. This drug employed as a prophylaxis in this study was milnacipram. The effect of the antidepressant drug lasted for about 2 years. Supported by Reid et al (2011), Narushima et al (2003) also notes that the effect of antidepressants such as SSRIs and others is much more superior to a placebo.

Miller et al (2005) noted that in primary care settings, the referrals for patients with depression with mental health specialty clinics were high when a diagnosis of CVA or CVD was being made. The referrals and the problems were especially high when a large number of medications were taken.

Vataja (2004) noted that a brain lesion in the pallidum strongly predicted for depression following stroke. Earlier, several studies were disproved as they could not precisely suggest the location of the brain infarct that could result in depression (Rickards, 2005). When the brain rehabilitation programme enabled greater rapport between the client and the therapist, the outcomes were better (Schonberger, 2006). Neglect in post-stroke patients increased risk of depression (Williamson, 2011).

6. Conclusion

Incidences of cerebral vascular accidents are on the rise. This is attributed to lifestyle changes and increased longevity. A significant proportion of the stroke patients will develop depression. Depression in stroke patients is associated with poor outcomes. It is futile if we as the health care providers fail to address the CVA and its risk factors. With good dietary habits and exercise, most of the CVAs can be prevented. Though screening for depression in post stroke patient has been shown to be effective, minimal research has been done in assessing the best screening tools (Miller and McCrone, 2005). This is a potential area for further research. It will enable disease prevention, rather than cure, which will decrease the disease burden. Henceforth, a research question that comes up is “what are the best practices in screening for depression in stroke patients?”

References List

Anderson CS & House AO (2004) Interventions for Preventing Depression afterStroke: The Cochrane Library Issue 3

Buijck B Zuidema SU Geurts AC Spurit-van EM Koopmans RT (2012) Neuropsychiatric symptoms in geriatric patients admitted to skilled nursing facilities in nursing homes for rehabilitation after stroke: a longitudinal multicenter study. Int J Geriatric Psych 27(7) p734-74 online at: HYPERLINK “http://www.ncbi.nlm.nih.gov/pubmed/21932248″http://www.ncbi.nlm.nih.gov/pubmed/21932248 [ Accessed on : 01 December 2012]

Burvill P W Johnson G A Jamrozik KD Anderson CS Stewart-Wynne EG Chakera T (2005) Prevalence of depression after stroke: The Perth Community Stroke Study. British Journal of Psychiatry 166 pp. 320 – 327

Calpadi VF & Wynn G (2010) Post stroke depression: treatments and complications in a young adult Psychiatr Q 81(1) p73-79 oneline at: HYPERLINK “http://www.ncbi.nlm.nih.gov/pubmed/20033774″http://www.ncbi.nlm.nih.gov/pubmed/20033774 [ Accessed on : 10 December 2012 ]

Chau JP Thompson DR Chang AM Woo J Twinn S Cheung SK Kwok T (2010) Depression among Chinese stroke survivors six months after discharge from a rehabilitation hospital J Clin Nursing 19 [21-22]

Describe a variety of assessment tools including interest, abilityintellectual level, achievement level

Describe a variety of assessment tools including interest, abilityintellectual level, achievement level

Assessment Tools

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Describe a variety of assessment tools including interest, ability/intellectual level, achievement level, and personality type assessments. At least 4 assessment tools must be chosen for each category in the previous sentence. Include a short description of each tool.

Personality type assessments- are tools used to determine the characteristics of a person, one of the tools is the aptitude test that measures how efficiently one can perform in their particular area (Hensen, 2004).

The Myers-Briggs Type Indicator (MMTIC) assessment can assist children to comprehend themselves better, and give parents and teachers better ways and methods to reach children with different learning styles.

Insight Inventory is another tool that can evaluate personality; it provides a common sense format of balanced view of behavior. Self-scored within minutes, Participants adopt important behavior skills, including how to adjust their style to manage conflict, and improve on team work (Hensen, 2004).

Human metrics Jung Typology Test- uses methods, questionnaires, scores and software appropriate to Human metrics. This is based on Carl Jung’s and Isabel Briggs Myers’ typological research on personality coupled with strengths of preferences and the description of one’s personality.

The Personality Questionnaire for Kids- helps to evaluate how a child views the world. This can be used to determine how they will respond to external stimuli and change in environment for instance change in school (Aiken, 2002).

Interest can be assessed by

The 16PF interest test- measures the interest of an individual based on self reporting, it is usually conducted without the knowledge of the person so as to be able to tell their exact interest without pretext

Smart interest test- this measures how far one is will to allow changes and how well they can adapt to these changes simply because they fall within their interest brackets.

CAT tests are administered to determine the maximum performance and interest of an individual and assess whether they are currently living them in their lives.

Vocational interest measures the development of interest, how long it takes for an individual to develop interest in something that is meant to be for their benefit.

Tools for assessing intellectual level are;

The Reynolds Intellectual Assessment Scales- is administered individually and is based on the measure of intelligence based on the memory. It is suitable for individuals between ages of 3-90 years and includes both verbal and non verbal interpretations of answers. Different have different questions (Aiken, 2002).

Formative assessments- It is also referred to as diagnostics testing. It is mostly used in the education system by teachers to evaluate the improvement on students. It is based on qualitative feedback and is often conducted periodically in an effort to make proper comparisons (Hensen, 2004).

The Stanford-Binet-5- it is used to measure intelligence. It focuses on the areas of verbal reasoning, quantitative reasoning, abstract/visual reasoning, and short term memory. It is used to determine how well and clear memory can be and is most appropriate for people aged between 6-70 years.

Wechsler tests- it is an adult and children intelligent scale that focuses on individual ability to adopt to changes in the environment and at the same time to look for solutions to problems.

Achievement can be assessed by

Broad- spectrum tests can be used to measure achievement and include Woodcock-Johnson Achievement Tests; – It measures fundamental skills, ease in a subject and capability to use skills. For instance reading, tests will measure ability to decode words, knowledge of phonics, ease in reading fast and accuracy in understanding.

Wide Range Achievement- it measure how well an individual is able to read statements, understand phrases and calculate mathematics with ease. It allows for testing within a short period of time and has no effects on the individual being tested. It is appropriate for individuals between the ages of 5-94 years.

Product -Gray reading tests- it is based on oral reading and shows the development and improvements that take place in children as they become more and more efficient in their reading. Achievement testing shows a child’s levels of academic performance compared to a standard peer group (Aiken, 2002). Children can be compared to age or grade peers or to children of lower or higher ages

Test of Reading Comprehension and Test of Written Language. It depends on the subject depth to be evaluated but mostly focuses on the ability to understand the written language and to translate it into the written words without assistance from any one. It is mostly conducted on children in order to determine the strides ad improvements that they are making (Hensen, 2004).

Criterion-referenced tests (CRT) – measures what the person is able to do and indicate what skills have been mastered. This is appropriate to work stations as it can be able to help to pick out the best individual suited for a promotion due to increase in competency.

Cognition Assessment

Cognitive assessment can be vital especially in detecting dementia in older adults and ADD in younger children

Mini Mental state Examination (MMSE), – this mostly evaluates the memory of a person and how well and clear it is. Especially in older adults when the memory is not good and they easily forget things it is usually a sign of clinical schizophrenia.

Attention analysis test – this analyzes how easy it is to capture and loose the attention of an individual. This is especially so in younger children whose attention is expected to be easily captured by new things and experiences. If these things do not capture the attention of a child they may be suffering from acute to severe case of retard.

The MGF planning test – this is a test that is used to determine if an individual can be able to plan something and execute the very way it was planned. In children it is determined by use of toys that are stacked up and crumbled and the child is asked to make it to appear the way it was before.

PEPP assessment – this deals with comprehension of language and how it is translated and put down on paper (Hensen, 2004). It measures the ability and capability of a person to understand his environment and come up with a structured way in which it operates and how it should operate.

References

Hensen Michel, (2004), Comprehensive Handbook of Psychological Assessment, Springer Publishers, Washington D.C

Aiken R. Lewis, (2002), personality Assessment: Methods and Practices, Prentice Hall Press, New Jersey.

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Descartes Philosophy on the Significance of the Body to the Mind

Descartes Philosophy on the Significance of the Body to the Mind

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Descartes’ Philosophy on the Significance of the Body to the Mind

Mind-body problem is the nature of association between the soul and the consciousness. It is mainly addressed by Rene Descartes who was a great French philosopher and mathematician in the 17th century. In philosophy, mind-body problem studies the relationship between matter and the mind. His views about mind and body results in Cartesian dualism, a believe that sensory organs are the ones which pass inputs to the epiphysis in the brain and then to the immaterial spirit. He also believed that the body is controlled by the mind through the pineal gland which is the principal organ where all thoughts are formed. Due to Cartesian dualism, different styles have emerged most being dualist and monist. Dualism ensures a rigid differentiation exist between the two organs (body-mind). Monism on the other hand measures the uniformity body and mind. Monism exists in three forms that is physicalism, idealism and neutral monism. Physicalism states that the mind is made up of matter arranged organized in a structured format while idealism holds that the existence of matter is an illusion that only exists in our thoughts. In neutral monism, matter and the soul are only unique essence that is identical to none of these two organs.

Descartes further asserts that the spirit and matter are distinct kinds of substance. He categorizes minds as unintended, thinking and feeling substances while bodies as extended substances incapable of feeling or thought. Substance dualism for example holds that mind/soul is made from uncommon type of substance which is not governed by either law of physics. On the other hand, property dualism entails that thou laws of physics are valid universally, therefore not fit in explaining the mind. However, it is difficult to identify how they could causally interact if they are radically different kinds of substance as argued in Princess Elizabeth’s letter.

Mind-body interaction plays a critical role in pretheoretic conception of agency since human soul can be able to determine the movement of animal spirits in the body in order to do voluntary acts being a conscious substance. Mental causation also aids in the formulations of the dualism relationship between matter and spirit/mind. Psychological explanation further defines the intelligibility of mental causation whereby if ones beliefs and desires are causally isolated from his or her bodily behavior, then what goes on his or her mind could not explain what he or she does. As a result, moral responsibility will be noticed if psychological explanation goes through hence leading to a satisfactory solution to the problem of mental causation.

On the other hand, Leibniz being a rationalist philosopher was also committed in his two theses about mind body perception.

Firstly, he argued that the spirit/soul has specific innate ideas. Secondly, he believed as well in the sufficient reason theory whereby everything has a reason for its cons and pro. Due to his principle having huge metaphysical consequences, it led him to state that the existence of the world is explained by the theological principles of God. Leibniz claims of reason therefore had some consequences about the metaphysics and nature that deals with fundamental questions on the existence of casual existence relationship between our thoughts and physical nature. He advanced the theory of pre-established harmony in order to respond to the body-mind nature of association. The theory stated no interaction between substances whereby the mind proceeded and unfolded respective to its own laws. Moreover, the body moved irrespective of the governing principles with such movement being in a perfect harmony state. He believed that there are simple substances called monads which are mind-like beings with forces that man all phenomena. As a result, space and time aid in cradle of the bodily phenomena since simple substances man matter and motion philosophy.

Szasz focuses on in the body-mind differential principles. He views the body and mind as separate concepts representing different types of phenomena. In his argument, both the soul and the mortal body cannot take the same direction, for instance sickness, as the mind is just but a metaphoric creature. Mind and body are therefore not only separated but two distinct object that function independently and responding differently to environmental variables. He further points out that from the ego’s point of view; the mind is part of the body. Mind and body are inseparable and distinguishable by double aspectism. There is a sort of separate mind and body since experimental and cognitive aspects can be differentiated from physical aspects. Physical brain constitutes the mind. The brain forms a critical body part which is a physical attribute of epiphenomenalism. The physical body affects the mind but the mind has no influence on matter/body. For instance, had the body been a TV, the mind would picture when the TV is switched on/off. Hence, this only affects the mind in picturing being a TV and the body. Therefore, any mental event has no influence on the activity of the brain.

Consequently, the body-mind relationship can be seen through physicalism, substance dualism and dual aspect theory. Materialism is the perception that the spirit and the soul have a link with matter and can be reduced to matter. Substance dualism explains mind and body as distinct substances which are unique whereby mind is un-extended and body extended. Using Nagel’s perception, mental properties cannot be reduced to physical properties pertaining dual aspect theory but they are two different ways of looking at the same thing. Dualism and mutualism of the mind has been in existence since the times of Plato and Aristotle. Dualism has been the driving force for the existence of the mind and body problem. Perception of the soul has influence over the body is beneficial since the body can heal whereas the mind expedites recovery. In our everyday activities, the mind frequently displays wonders of thought, memory, logic and creativity. It therefore has power to do great things.

Mind and body affect the human interaction as well. During interaction, both the body and mind have influence over each other because they are both involved in the interaction. According to Descartes, it is the space extension that makes us physical creatures and our ability to think is what constitutes our mental being. His words Cogito Ergo Sum implied to mean “I think, therefore I am” creates a problem since the mind exists a separately from the body with no physical association. Occasionalism explains the relation of mind and body. In many occasions, it seems that God keeps watching over us daily and makes things happen with the mind instructing the body. It solves the problem of how the mind and the body affect one another. Its weakness is the assumption that God watches over us daily.

Explanation of body-mind with reference to circular causation sounds more appropriate and relevant than linear causation. Different correlations have been studied in neuroscience between brain activity and conscious experiences. Consciousness which is a biological process of molecular signaling and interaction of the nerve cells therefore remains a challenge since relating it directly to brain activities is difficult and yet to be proven as a process. However, daily science increasingly gets interested in human perception, action and thinking. It dwells on how the human body interacts with its surroundings and the way in which those particular interactions shape the mind of a human body. This is evident in the Cartesian divide between the immaterial mind and the material existence of human beings (Damasio, 1994). A study of bodily actions provides a bridge across the mind-body relation. This is because they neither react to external stimuli nor indications of mental states which only contain relationships to the features of the action. On the other hand, parallelism shows the non-existence of a relationship between matter and the immortal mind. When one’s mind decides dictate the body rhyme, it becomes a coincidence that the body walks over there. They only appear to. This therefore brings in mind the body-mind correlation concept as described by God in the case of Leibniz in Pre-established Harmony.

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Describe a significant social or technological event of the 20th century

Describe a significant social or technological event of the 20th century

Effects of Landing on the Moon

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Effects of Landing on the Moon

For centuries, man was fascinated with the idea of walking on the moon. In 1969, Neil Armstrong, an American Astronaut, changed this fantasy to reality by setting the first human footprint on the moon. This pioneering technological feat by the Apollo 11 crew inspired further cosmic explorations and placed America in the annals of history and at the leading position in terms of technological innovations (Moroz, Huntress, & Shevalev, 2003). Landing on the moon propelled the industry response that was hitherto uneven, perhaps justifiably due to the lessons learned from the disappointments of previous missions. Space enthusiasm continues to grow across the globe as nations develop new planetary exploration techniques for economic, national security, and research purposes. Landing on the moon triggered a spirit of confidence in the human capital, opened up new opportunities for future explorations, and enhanced competition in modern society.

Landing on the moon takes credit for inspiring confidence in the human capacity to withstand even the perceived insurmountable challenges. Not only does the missions to the moon and other planets inspire confidence in people but also brings a sense of pride and positive perspective on the capacity to succeed in any mission. Notably, the emotional significance of landing on the moon emerges from the fighting spirit in people and their desire to explore new opportunities in other planets regardless of the challenges involved. On a wider context, modern planetary expeditions seek to find solutions to social, medical, and economic problems, and explain religious myths about the moon and other night sky objects (Steyaerta & Katzb, 2004). The new research findings from space explorations serve as unifying forces and boost the belief in people’s individual and collective strength.

Today, space explorations benefit society by providing new research and financial opportunities. Space entrepreneurs and explorers make profits by facilitating space travel and providing new information for planetary research. Several major airline companies like Virgin Galactic and Rocket Ship Tours create sophisticated crafts that facilitate space travel (Steyaerta & Katzb, 2004). These companies continue to grow in profit and popularity owing to the increase in the number of space enthusiasts. People wish to learn more about the abundant space and mineral resources available in the solar system that offer solutions to Earth problems. The potential for Mars to support human life and its iron rich soil are example of benefits that can be channeled towards helping the population and mineral limitations on earth.

Many nations engage in military, political, medical, and technological competition that stem from the Space Race. This popular rivalry, which resembles the Cold War, pitted the Soviet Union against America in the quest to achieve dominance over space explorations (Moroz, Huntress, & Shevalev, 2003). President Kennedy made a passionate appeal Americans to counter the Soviet’s dominance of space explorations by giving an inspiring speech to the nation to support its astronauts both morally and financially. This historic speech was not in futility because Armstrong set the first human footprint on the moon a decade later. Other nations perceived this as a challenge and trigger to modernize their space activities to surpass the American achievement. Today, nations rival one another on political, economic, social, medical, research and other issues as a result of the previous competition for space explorations dominance.

Landing on the moon opened up new frontiers for future exploration, inspired a belief in the unlimited human capital, and fueled rivalry among societies. People recount the successful mission to the moon and get a feeling of pride and inspiration to prevail over any hurdles in their endeavors. Modern space explorations open up numerous opportunities for further research to find solutions to problems on Earth and facilitate entrepreneurship for private gain. The enduring modern social, political, economic, and technological rivalries among nations are akin to the Space Race and the Cold War that pitted the Soviet Union against America.

References

Moroz, V., Huntress, T., & Shevalev, L. (2003). Planetary Missions of the 20th Century. Cosmic Research. Volume 40, Issue 5, pages 419-445.

Steyaerta, C. & Katzb, J. (2004). Reclaiming the space of entrepreneurship in society: geographical, discursive and social dimensions. Entrepreneurship & Regional Development: An International Journal, Volume 16, Issue 3, 2004, pages 179-196.

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Depression in children

Depression in children

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Depression in children

Introduction

Like in teenagers and adults, depression is the most prevalent psychological disorder in children. This is certainly surprising since many people hold the notion that children have nothing stressing them enough to fall into depression. However, children stand a higher risk of falling into depression than elders. This is mainly due to their inability to fight back, lack of understanding, lack of power to tolerate harsh times, homesickness and a relatively easy inclination to what is wrong. These factors underline not only the reality but also the possibility of depression in children. According to studies, depression in children is a grave issue that mainly affects children between the age of 4 and 12. Being at relatively young ages, these children find it difficult to comprehend what is happening or even talk with somebody about it. Unfortunately, their inability to express themselves in case of depression is considered also normal for children in this age group. This brings to the fore two critical issues; difficulty in diagnosing the problem and suicidal thoughts or tendencies. The suicidal thoughts emanate from their inability to have a clear judgment for their thinking, in which case they hold the notion that they had rather die than live a strangely difficult and alien life. While this analysis places an overwhelming responsibility on the parents to be on the lookout for the varied signs of depression in their children, evaluating the causes of the problem is crucial (Goodyear et al. 96). It has always been thought that depression in children results from variations in hormones, traumatic situations and even low self esteem or confidence. While these may trigger the depression, it is necessary to acknowledge that some children are more predisposed or vulnerable to becoming depressed than others, thanks to their genetic make-up. This underlines the fact that hereditary factors play a key role in the occurrence of depression in children.

Supporting arguments for depression in children as a hereditary problem

Studies on twins- the larger part of what is known of genetic influence on depression is based on research done on twins, both fraternal and identical. Identical twins have particularly been extremely helpful in this research since their genetic code is exactly the same. Studies show that in cases where one of the identical twins falls into depression, the other one also develops depression about 76 percent of the times. In cases where the identical twins are brought up apart from each other, both fall into depression in about 67 percent of the times. While there is a ten percentage variation, one would acknowledge that genetic influence on depression in children is quite strong (Scott and Joughin 57). The fact that the rate is not a 100 percent underlines the fact that other factors influence an individual’s vulnerability to depression. However, these other factors only serve as the trigger for depression (Rutter and Taylor 77).

This notion is cemented by studies done on fraternal twins. Fraternal twins do not have similar genetic code but only share approximately 50 percent of the genetic makeup. Research on fraternal twins shows that when one of the fraternal twins falls into depression, the other twin also falls into depression in approximately 19 percent of the time. This is quite low compared to the high rates in the case of identical twins, which points at the strong influence of the genes. In addition, it is noteworthy that the rate is still way higher in comparison to the rates in the general public (Goodyear 59). This points at the influence of genetic makeup given that the high rates can be attributed to the shared 50 percent genetic makeup.

Genes for depression- numerous researches have been done in an attempt to identify the genes that lead individuals to develop depressive illnesses. While there is no consistency in the studies as to the specific genes that are responsible for the condition, results of a number of researches have suggested that specific genes cause depression in children to occur in certain families and mot in others. Much is not known about the predisposition or vulnerability imposed by genes to depressive illnesses. However, studies indicate the presence of a high likelihood that a combination of genes increases the vulnerability of an individual to depression (Scott and Joughin 49).

Legacy- while it was believed that the environment that a child is living in remains the main culprit for the depression, research show that there is inherited vulnerability and susceptibility to depression. Studies show that individuals with close relatives who at one time fell into depression stand a relatively higher likelihood of developing the condition (Scott and Joughin 37). The genes that individuals inherit from their parents determine numerous things about them such as their complexion, color of their hair and eyes, as well as their gender. In essence, the genes determine the illnesses that one may be more vulnerable to contract at one point in his or her life. Except in cases of identical twins, no two persons have a similar genetic makeup (Rutter and Taylor 76). Research shows that individuals with siblings or parents who have undergone considerable depression, are 2 to 3 times more likely to fall into depression compared to those who may not have relatives with the illness. In addition, such individuals stand higher chances of having bipolar disorder, a form of mental illness. In addition, it is noteworthy that the condition has been linked with changes in chemical composition in the part of one’s brain that is responsible for controlling moods. The variations hinder the brain from functioning normally thereby resulting to depression. It has always been acknowledged that the brain and its functioning or reaction to particular situations is determined by an individual’s genes (Goodyear 49). In addition, bipolar disorder is strongly influenced by the genetic makeup of the individual. Studies show that about fifty percent of individuals with bipolar disorders have a parent or parents who at one time suffered from depression. Children born of a mother or father with bipolar disorder stand a 25 percent chance of having clinical depression at one time in their lives. In cases where both parents have had bipolar disorders, the child stands a 50 to 80 percent chance of developing depression. Individuals whose siblings have bipolar disorder are 2-10 times more likely to have a serious depressive disorder compared to those that have no such siblings.

Conclusion

Depression in children has been remarkably prevalent in the recent times. However, it has been extremely difficult to diagnose it since its chief symptom is also a key characteristic of children between 4 and 12 years of age. However, given the seriousness of the condition, especially as far as having fatal results is concerned, it is crucial that the main causes be examined and remedied (Rutter and Taylor 46). Nevertheless, it is vital to acknowledge that genetics play a significant role in influencing its occurrence. In essence, twin brothers stand a higher chance of contracting the illness in comparison to the general public. In addition, individuals whose siblings or parents have had depression at one time or the other stand a higher chance of contracting the ailment (Rutter and Taylor 57). Studies also show that some genes or a combination of genes influence the occurrence of depression.

Works Cited

Rutter, Morris. and Taylor, Elly. ‘Child and Adolescent Psychiatry’ (4th edn). London: Blackwell. 2002. Print.

Goodyear, Alexander. The Depressed Child and Adolescent, second edition. New York: Cambridge University Press. 2001. Print.

Scott, Antony and Joughin, Collins. Finding the Evidence’ – A Gateway to the Literature in Child and Adolescent Mental Health (2nd edn). London: Gaskell. 2001. Print.

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