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Even the digital world with its drive for fast and efficient communication might leave space for different expectations on the part of the readership discount bupron sr 150mg amex bipolar depression lows. Arguably purchase 150mg bupron sr free shipping depression symptoms child, only surveys in the realm of reception studies might be able to cheap 150mg bupron sr fast delivery depression symptoms not sad offer a valid response buy discount bupron sr 150 mg on line mood disorder vs personality disorder. Conclusions the small size of the corpus does not permit significant generalisations or definitive conclusions and further research is required. It would also be interesting to combine a multimodal analysis of illustrations within the Table of Contents of the digital edition, in order to examine whether other semiotic signs could have influenced linguistic choices. Besides, the analysis should be extended to include a variety of sources, thus other popular science magazines. Still, a wider theoretical descriptive research could also be integrated with surveys in the area of reception, carried out by language experts. The ultimate aim of this paper – despite the small-scale case study – would encompass an attempt to formulate hypotheses about linguistic properties of remediated Tables of Contents in popular science magazines and to establish whether the result of this kind of intralingual translation could be considered as representative of a specific (new) Register/Genre. Borrowing Cronin’s words, also in the case of intralingual translation here discussed, [o]ne of the challenges [. Blum-Kulka (eds), Inter-lingual and Inter-cultural Communication: Discourse and Cognition in Translation and Second Language Acquisition Studies, Gunter Narr, Tubingen, pp. Fabricius-Hansen (eds), Information Structure in a Cross-Linguistic Perspective, Rodopi, Amsterdam New York, pp. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the prod uct information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trade mark. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or subli cense the work or any part of it without McGraw-Hill’s prior co sent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibit ed. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccura cy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indi rect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. Each question in the book is accompanied by an answer, a paragraph explanation, and a specific page reference to a standard textbook or other major resource. These books have been carefully selected for their educa tional excellence and ready availability in most libraries. One effective way to use this book is to allow yourself one minute to answer each question in a given chapter and to mark your answer beside the question. By following this suggestion, you will be training yourself for the time limits commonly imposed by examinations. For multiple-choice questions, the one best response to each question should be selected. For matching sets, a group of questions will be preceded by a list of lettered options. For each question in the matching set, select one lettered option that is most closely associated with the question. Since there are few absolutes in clinical practice, remember to simply choose the best possible answer. Some important topics are deliberately duplicated in other sections of the book when this is deemed helpful. When you have finished answering the questions in a chapter, you should spend as much time as you need to verify your answers and to absorb the explanations. Although you should pay special attention to the explanations for the questions you answered incorrectly, you should read every explanation. Each explanation is written to reinforce and supplement the information tested by the question. When you identify a gap in your fund of knowledge, or if you simply need more information about a topic, you should consult and study the references indicated. A 42-year-old man comes to the emergency room with the chief com plaint that “the men are following me. Which of the following psychiatric findings best describes this last belief of the patient A 32-year-old woman is seen in an outpatient psychiatric clinic for the chief complaint of a depressed mood for 4 months. During the interview, she gives very long, complicated explanations and many unnecessary details before finally answering the original questions. Which of the fol lowing psychiatric findings best describes this style of train of thought A 23-year-old man comes to the psychiatrist with a chief complaint of a depressed mood. Which of the following actions should be used to help develop rapport with this patient

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Of the following atypical agents discount bupron sr 150mg overnight delivery mood disorder 29699, which is likely to order bupron sr 150 mg on line depression test scores be the best choice for this patient Neurotransmitter abnormalities are involved in the etiology of many psychiatric illnesses order bupron sr 150mg free shipping economic depression history definition. Although normalization of neurotransmitter levels by pharmacologic agents can ameliorate many of the symptoms buy 150 mg bupron sr with amex depression kaiser, these agents cannot cure psychiatric disorders. Psychopharmacologic agents may also be useful in the treatment of symptoms of certain medical conditions. Antipsychotic agents (formerly called neuroleptics or major tranquilizers) are used in the treatment of schizophrenia as well as in the treatment of psychotic symptoms associated with other psychiatric and physical disorders. Antipsychotics are also used medically to treat nausea, hiccups, intense anxiety and agitation, and Tourette disorder. Although antipsychotics commonly are taken daily by mouth, noncompliant patients can be treated with long-acting "depot" forms, such as haloperidol decanoate or fluphenazine decanoate administered intramuscularly every 4 weeks. Antipsychotic agents can be classified as traditional or atypical depending on their mode of action and side effect profile. Traditional antipsychotic agents act primarily by blocking central dopamine-2 (D)2 receptors. Although negative symptoms of schizophrenia, such as withdrawal, may improve with continued treatment, traditional antipsychotic agents are most effective against positive symptoms, such as hallucinations and delusions (see Chapter 11). In contrast to traditional antipsychotic agents, a major mechanism of action of atypical antipsychotics appears to be on serotonergic systems. Atypical agents, particularly clozapine, may be more effective when used to treat the negative, chronic, and refractory symptoms of schizophrenia (see Chapter 11). They are less likely to cause extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome and so are now the first-line agents for treating psychotic symptoms. Atypical agents may increase the likelihood of hematologic problems, such as agranulocytosis (very low granulocyte count leading to severe infections), with clozapine as the most problematic agent. They may also increase the likelihood of seizures, anticholinergic side effects, and pancreatitis. Clozapine and olanzapine carry the highest risk of weight gain and type 2 diabetes; risperidone and quetiapine an intermediate risk, while ziprasadone, aripiprazole, and paliperidone appear to carry little risk. Antidepressant agents do not elevate mood in nondepressed people and have no abuse potential. Stimulants, such as methylphenidate or dextroamphetamine, also may be useful in treating depression. They work quickly, and thus may help to improve mood in terminally ill or elderly patients. They are also useful in patients with depression refractory to other treatments and in those at risk for the development of adverse effects of other agents for depression. Heterocyclic antidepressants block reuptake of norepinephrine and serotonin at the synapse. These agents also block muscarinic acetylcholine receptors, resulting in anticholinergic effects. Histamine receptors also are blocked by heterocyclic agents, resulting in antihistaminergic effects. Other adverse effects include cardiovascular effects, such as orthostatic hypotension, and neurologic effects, such as tremor, weight gain, and sexual dysfunction. These agents may be particularly useful in the treatment of atypical depression (see Chapter 12) and treatment resistance to other agents. Increase in tyramine can cause elevated blood pressure, sweating, headache, and vomiting. Reaction characterized by autonomic instability, seizures, delirium, hypertension, tachycardia, muscular rigidity, and elevated body temperature. Lithium is a mood stabilizer used to prevent both the manic and depressive phases of bipolar disorder. It may be used also to increase the effectiveness of antidepressant agents in depressive illness and to control aggressive behavior (see Chapter 20). Antipsychotics are therefore the initial treatment for psychotic symptoms in an acute manic episode. Anticonvulsants: carbamazepine (Tegretol), oxcarbamazepine (Trileptal), valproic acid (Depakene, Depakote), and others 1. Anticonvulsants are also used to treat mania, particularly rapid cycling bipolar disorder. Carbamazepine may be associated with severe adverse effects, such as aplastic anemia and agranulocytosis. Valproic acid may be particularly useful for treating bipolar symptoms resulting from cognitive disorders (see Chapter 14) and for prophylaxis of migraine headaches. Adverse effects of valproic acid include gastrointestinal and liver problems, congenital neural tube defects, and alopecia (hair loss). Other anticonvulsant agents that appear to have mood-stabilizing effects include lamotrigine (Lamictal), gabapentin (Neurontin), topiramate (Topamax), and tiagabine (Gabitril). These agents have a short, intermediate, or long onset and duration of action and may be used to treat disorders other than anxiety disorders (Table 16-3). Their characteristics of action are related to their clinical indications and their potential for abuse; for example, short-acting agents are good hypnotics (sleep inducers) but have a higher potential for abuse than longer acting agents. Zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem) are short-acting agents used primarily to treat insomnia. Propranolol (Inderal) blocks the action of epinephrine on both 1 and 2-adrenergic receptors. It is most commonly used to treat major depressive disorder that is refractory to anti-depressants. A 22-year-old man with schizophrenia who has been taking an antipsychotic for the past 3 months reports that recently he has experienced an uncomfortable sensation in his legs during the day and must constantly move them.

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The genogram also clarifies the “sides of the family” issue in most marriages and the tendency for traits or problems to generic 150mg bupron sr otc depression symptoms reddit skip generations because children use their parents as a negative reference bupron sr 150mg amex depression symptoms relapse. Many family theorists (for example generic 150mg bupron sr with mastercard mood disorder with anxiety icd 9, Jay Haley and Paul Watzlawick) suggest that two things occur when a symptom is described to buy discount bupron sr 150mg anxiety 3000 a family: the family is challenged with an entirely original reappraisal of its experience, and it is influenced by the change agent. If the family accepts the therapist’s suggestion, the influence of this change agent is clear, and it can be used for future interventions. If the family resists the suggestion, the family shows itself its own power and moves toward health. You should accept concerns that acceptance of the paradoxical instruction (“Go home and beat your children; it’s how you show your love”) can be dangerous. However, an analogue study shows that although students find paradoxical interventions less acceptable than nonparadoxical ones, they do not negatively influence the perceptions of the therapist’s expertness or trustworthiness (Betts & Remer, 1993). The impact of paradoxical interventions on perceptions of the therapist and ratings of treatment acceptability. A series of articles in Psychological Bulletin illustrates the difficulties in performing therapy effectiveness research. It also shows students how researchers from different viewpoints can interpret the same information differently. Bowers and Clum (1988) performed a meta-analysis on 69 studies comparing behavior therapy with placebo and nonspecific treatment conditions to assess the value of behavior therapy for a wide range of conditions. Several years later Brody, (1990) argued that the meta-analysis gave a misleading picture. Brody noted that a wide range of behavior therapies (systematic desensitization, meditation, social-skill training, and so forth) and patient problems (test anxiety, Copyright © Houghton Mifflin Company. Brody took the ten studies that involved “neurotic” conditions such as agoraphobia and anorexia and did a simple box-score to see if behavior therapy was more effective than placebo conditions. Brody concluded that there was no evidence for the superiority of behavior therapy. Therefore, the outcome studies and the meta-analysis on which they were based did not yield clinically significant information. The same data prove both that behavior therapy is superior and is not superior to placebo treatment conditions; the result depends on the method of analysis. Relative contribution of specific and nonspecific treatment effects: Meta-analysis of placebo-controlled behavior therapy research. The ethics of methodologically sound psychotherapy-effectiveness research is a good topic for discussion. Ask students to suggest an appropriate control group for a study of treated individuals. If they respond, “people who do not receive treatment,” point out the possibility that people who ask for help (and get it) may be different in some outcome-relevant way from people who do not ask for help. Further, how can we be sure that untreated people do not get some other form of help (for example, read a self-help book) that might be much like therapy These questions highlight the problem of random assignment, a key component of true experiments. A second kind of control group, the waiting-list control, includes random assignment but has its own problems. Ask students how they feel about the ethics of arbitrarily placing people in distress on a waiting list. A third option is a pseudotherapy control group—the psychological equivalent of a placebo pill. The American Psychological Association site for ethical principles of psychologists. The common components of psychotherapy mentioned in the text are reasonable and accurate. Jerome Frank’s view of psychotherapy—and, in fact, of all forms of healing and persuading—can be added to the discussion. Frank, in his classic book, Persuasion and Healing, argues that the social aspects of the therapeutic relationship overwhelm any technical or theoretical considerations. According to him, the three active ingredients in the change process are (1) a socially sanctioned healer whose powers and status are respected by the sufferer, (2) a sufferer who seeks relief from symptoms, and (3) a fairly structured set of contacts (with their own rituals) that convinces the sufferer to change his or her attitudes and behavior. Key to this last process is the sufferer’s need to have mysteries explained by the healer and to feel that there is hope for improvement by relying on the expert. Ask students whether the same analysis can be applied to faith-healing evangelists or voodoo doctors. Chapter 17: Therapeutic Interventions 287 Imagine out loud this “therapy” with your students: A charismatic person writes a book and appears on television talk shows arguing that depression and fatigue are the result of certain allergens and toxic chemicals seeping into people’s bloodstreams through their clothes. The offending chemicals, this person asserts, come from polyesters and other synthetic fabrics and from modern laundry detergents. The cure is for people to throw away all their garments except for 100 percent natural cottons and wools and to wash only with “pure” soap. Given the mystery of depression and fatigue, the desperation of some, the status afforded television appearances, and the effort involved in the treatment, it is fairly likely that such a “therapy” could catch on (and be successful) with some sufferers. The most common form of community psychology activity is mental health consultation, a form of secondary prevention in which mental health professionals provide information to non–mental health professionals about a disorder, its causes, symptoms, and ways to make referrals. The professionals most often involved have frequent contact with troubled individuals but are not specifically trained to interact with them. For example, school teachers, police officers, and emergency room nurses often come in contact with distressed individuals and need to know how to best interact with them and make referrals to professionals when necessary. Ask students to think of other professions that have this kind of frequent contact with distressed individuals. Some examples are funeral directors, clergymen, general practice physicians, bartenders, hairdressers, and divorce attorneys.

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