Monthly Archives: November 2017

Mandatory Incarceration for Chronic Juvenile Offenders

There should not be mandatory incarceration for chronic juvenile offenders because, according to the findings of a study conducted by the Rand Corporation, the greater the number of juvenile arrests a chronic juvenile offender has, the more likely s/he is to continue as a chronic offender into adulthood (Greenwood, Zimring p. 8). That being the case, it is more viable to look at the commonalities which lead to chronic offending in juveniles and utilize this information to develop alternative programs to incarceration in juvenile detention centers.

This would not help curb continuing maladaptive behavior, as incarceration does not address the issues from which chronic offending stems, nor does it encourage juvenile offenders to change, of which they are more capable than their adult counterparts. This is according to the findings of the justices in the Supreme Court case, Graham v. Florida, in which they stated…”parts of the brain involved in behavior control continue to mature through late adolescence (which would include early adulthood)…Juveniles are more capable of change than adults…” (Bartollas, Schmalleger p. 2). There are a number of contributing factors, which contribute to chronic juvenile offending and as stated earlier, none of them are addressed by incarceration. If change is more likely to be possible, in juvenile offenders, then contributing factors should be determined and remedied through rehabilitation programs, when it is deemed to be viable.

The court should be lenient toward a chronic offender once s/he has been evaluated by social workers and psychologists to determine whether contributing factors exist which would make him/her a good candidate for a rehabilitation program. The Rand study finds that these including five groups of factors. The first group looks at family characteristics indicating inadequate parenting (i.e. alcoholism, mental illness, criminal behavior of parent(s)/siblings). The second factor is biological or physical deficits, in the child (i.e. impaired neural development, including certain birth defects, irregular EEG, slow autonomic nervous system) which may impede normal social development. The third factor focuses on parental consistencies and attitudes regarding displays of affection, supervision and consistent application of appropriate discipline or reward for bad or good behavior. The fourth looks at a set of pre-delinquent behaviors such as disobedient, stealing, lying, wandering, excessive aggression, and truancy amongst younger children and heavy drinking or smoking, drug use, promiscuous sex, and fighting amongst older children. The final and fifth category is criminal acts up to the point of evaluation (Greenwood, Zimring p. 8). With these factors determined, targeted rehabilitation can be sought in lieu of harsher punishments, such as mandatory sentencing in juvenile detention centers. While incarceration fosters increased delinquency, rehabilitation taps into the juvenile’s innate ability to change, due to his/her continually developing brain.

References:

Bartolla, C.; Schmalleger, F. (2018) Juvenile Delinquency, third edition. Retrieved from: Colorado Technical University https://ebooksbvd.my-education-connection.com/read/9781323786857/i

Greenwood, P.; Zimring, F (1985, May)  One More Chance: The Pursuit of Promising Intervention Strategies for Chronic Juvenile Offenders. Retrieved from: https://eric.ed.gov/?id=ED266386

Treatment, Rather than Confinement, is the Solution to Dealing with Status Offenders

Abstract

Status offenses are those which are only illegal if committed by a juvenile and as such, should not be treated as crimes. It is to the benefit of both the status offender and the taxpayer if these juveniles are approached as in need of treatment, rather than punishment and processed separately from juvenile criminal offenders. This method will produce better results, in the long run, both for the juveniles in question and society as a whole.

Treatment, Rather than Confinement, is the Solution to Dealing with Status Offenders

 

Status offenses are those which are only crimes when committed by someone under the age of majority. They include truancy, breaking curfew, running away, and incorrigibility (Bartollas, Schmalleger, 2018 p.7). These behaviors are unlikely to be curbed by processing through the juvenile courts and placement in a juvenile detention center. To the contrary, such treatment frequently leads to further delinquency, including escalation to criminal acts (Arthur, Waugh, 2009, p. 556). Status offenses are the proverbial “cry for help” of troubled youth. Status offenders “…often come from broken homes, have suffered childhood trauma, and have unmet mental health and education needs (Arthur, Waugh, 2009, p.555)”. In light of these facts, it is to the advantage of both the taxpayer and the juvenile to split the juvenile courts into two sections, for processing of those accused of criminal acts through one and status offenders through the other. Separating them improves the potential for rehabilitation in status offenders and results in lower costs for taxpayers, as these juveniles are less likely to become lifelong chronic offenders. This method is proven to be effective, while the reverse is true of punitive measures (Arthur, Waugh, 2009, p. 557).

 

By processing juvenile status offenders separately from minor criminal offenders, not only are status offenders kept from being treated and feeling like criminals; this prevents them from mixing and thereby being influenced by criminal offenders (Arthur, Waugh, 2009, p. 558). Teens, in general, are at a high risk of succumbing to peer pressure. Teens who are likely to commit status offenses are at an even more significant threat, because inadequate parenting, childhood victimization, and emotional or mental problems leave them in a state of heightened vulnerability (Greenwood, Zimring p. 8).

 

Ergo, processing and incarcerating them like criminals makes them feel like they are already criminals. Then the exposure to actual lawbreakers, who commonly brag about their exploits, increases the likelihood that they will escalate to more serious offenses. If instead, the court system approaches their cases as those in need of treatment programs, they may be able to benefit from their encounter with the court. They could get the help they need to get on the right path to becoming healthy, productive members of society (Arthur, Waugh, 2009, p. 565). When this occurs, they become contributors to civilization rather than a drain. They grow up to have careers, through which they both serve the social order and pay taxes, as opposed to being a burden and costing the taxpayers money for the rest of their lives. While funding treatment may seem more costly upfront, it will amount to much less than continued incarceration, in the long run.

 

According to Arthur and Waugh (2009), “[m]any types of services have been proven effective in reducing rates of incarceration and status-offense misbehavior” (p. 565). These can include but are not limited to therapeutic foster care, both individual and family counseling, respite care, and temporary crisis shelters (Arthur, Waugh, 2009, p. 565). As previously stated, while these services may seem more costly upfront, they are less expensive than detention, both in the immediate and distant future. Unfortunately, not all at-risk teens will benefit from alternatives to incarceration and will inevitably end up on the path of lifelong criminal behavior, which is why it is essential to identify and assess these youths as early as possible. This juncture is where programs such as Wisconsin’s FAST, or “Families and Schools Together” come into the picture. By collaborating with children and their parents to create a sense of accountability and liability, the program aids parents in comprehending their part in their children’s education (Arthur, Waugh, 2009, p.565).

 

Finally, as stated in the beginning, status offenses are not actual crimes. As such, their perpetrators do not benefit from punitive consequences, which have the often negative result of making a dangerous situation worse. Instead, status offenders should be handled as individuals in need of treatment for family troubles, post-traumatic stress, mental illness, emotional problems or learning disabilities causing them to act out. These children are vulnerable and are in need of special care and attention, not punishment.

 

 

 

 

 

 

 

 

 

 

 

References

Bartolla, C.; Schmalleger, F. (2018) Juvenile Delinquency, Third Edition. Retrieved from:  https://ebooksbvd.my-education-connection.com/read/9781323786857/i

Greenwood, P.; Zimring. F. (1985, May) One More Chance: The Pursuit of Promising Strategies for Chronic Juvenile Offenders. Retrieved from: https//:eric.ed.gov/?id=ED266386

Arthur, P.J.; Waugh, R. (2009) Status Offenses and the Juvenile Justice and Delinquency Prevention Act: The Exception that Swallowed the Rule. Retrieved from: https://law.seattleu.edu/Documents/sjsj/2009spring/Arthur%20Waugh%208%200.pdf

My Victim Advocacy Program

My Victim Advocacy Program

I selected the National Crime Victims Survey (NCVS) as my source that compiles crime data. The reason I chose the NCVS is that crime, particularly personal crime, is underreported and sources based on police reports may not be as representative of actual victim pools. According to the Bureau of Justice Statistics website, twenty percent of property crime and fifty-one percent of personal crime went unreported, from 2006 to 2010 (2015). Regardless of whether a crime is reported to the police, victims will still experience trauma and/or financial loss, as a result of the crime. They may still seek out other sources to aid them in coping with the aftermath of the crime, even if they do not report it. Help should be available to them. It is more than enough to be the victim of a crime. No one should ever feel the isolation of being left to cope with it alone.

The Office of Justice Programs website states that the NCVS contains self-reported data from roughly 90,000 households, encompassing about 160,000 persons relating to personal crimes, including rape/sexual assault, simple and aggravated assault, robbery and personal larceny, along with domestic property crimes such as burglary, vandalism (1973-2015). The respondents provide information about their gender, age, race, marital status, level of education and income; as well as whether or not they experienced a victimization (1973-2015).  Data collected for each reported incident includes similar information about the offender, along with features of the crime (including time and location of event, use of arms, type of damage, and financial results), whether the offense was reported to police, reasons why it was or was not reported, and victim experiences with the criminal justice system (1973-2015).

The basic goals of my proposed program will be to provide crime victims with immediate, as well as ongoing support and services to aid them in overcoming the physical, psychological, and financial injuries they experience as a result of the crime that has been committed against them. Most often, after experiencing a crime, individuals are in shock or experiencing post-traumatic stress and this can leave them feeling lost, unsure of where to turn and what to do next. First and foremost, the objective of my program would be to simplify access to needful victim resources. The aftermath of a victimization can often be an overwhelming and confusing time. The last thing a crime victim should feel is “lost in the system” or unable to utilize the services available to them. Secondly, a goal of would be to provide a safe and comfortable environment that would help crime victims feel at ease as much as possible. Post-traumatic stress affects many crime victims, to varying degrees and will often avoid places or situations, in which they do not feel safe. For example, I would want a quiet reception area with an open waiting area, which would have furniture situated such that no one would walk behind it. Finally, my aim would be to hire a knowledgeable, experienced and empathetic staff of both men and women to work closely with clients in providing the services they need.

My program would be centered on services for victims of personal crime, including assault, domestic violence, rape, sexual assault and domestic violence, although there would also be some services for victims of property crimes, such as vandalism, robbery, and auto theft. For victims of personal crime, the main service I would provide would be crisis counseling. I would also provide shelter referrals, for domestic abuse victims and intimate partner rape victims, along with expert help in preparing petitions for personal protective orders. For victims of robbery, I would provide 1 to 3-day hotel vouchers, so they could stay in a safe, ordered place immediately following the incident. Homes and apartments are often left in shambles, in the event of a robbery, plus the occupants might not feel safe staying there immediately. For victims of auto theft, we would work closely with them to resolve their immediate transportation needs, to get to school and/or work. Most likely this would be in the form of bus tickets or tokens, but I would also provide taxi vouchers for those whose homes or destinations were not easily accessible by mass transit. For victims of vandalism I would have a partnership with a home improvement chain, to have them provide discounted materials to repair the damage and relationships with skilled workers who were willing to volunteer some of their time and labor. In addition to all of the latter, I would also provide targeted group therapy based on the type of victimization, gender, and age group, along with referrals to low-cost individual counselors.

 

 

 

 

Poverty and obesity

I will make this short and to the point.

Today I spent $168 on fresh fruit and vegetables, for a one week juice cleanse. That was the bill at the “cheap” health food store in town.

Alternatively, for the same $168 I could feed myself three meals a day, for 56 days, if I ate from the 99 cent menu at a fast food restaurant.

So why are there so many fat poor people? I think we have the answer here.

Virtual diagnosis –– bipolar I disorder

Making a diagnosis in a limited timeframe with only basic information can be a challenging proposition. Mental health professionals of all types are often required to do so when the treatment time is limited, as with psychiatric holds and court or school ordered treatment. Law enforcement Psychological Emergency Response Teams (PERT) may have mere moments of observation of a subject, on which they must base a preliminary diagnosis as the legal justification for an involuntary psychiatric hold. While in the hospital, a psychiatrist will have only minutes a day, in which to assess an individual’s psychological condition and use the information to prescribe treatment. Although this is the situation in which we find ourselves with Danny, we have more information than diagnosing professionals may have, and I believe we have enough information to make a diagnosis. We have the parents’ report of a previous attempt at self-harm to indicate a previous depressive episode, along with their admission that he had been sleeping only a few hours a night. Danny’s explanation of feeling “on top of the world” and the delusion of the running car being a “golden opportunity” suggest a current manic phase.

Still, if given the opportunity, I would certainly use it to probe Danny for more information. I would start off by explaining that my questions only served to give me better insight into Danny the person and their purpose was not to label or judge him in any way. I would ask him about his self-esteem, or in what regard he held himself. I would ask him if his depression altered this confidence. I would ask Danny if he often found himself presented with golden opportunities while feeling elated, or “on top of the world” as he phrases it. I want to know if he experiences racing thoughts and if he ever found they distracted him from reality. Another question would be if he ever found himself becoming irritated by small things or perhaps for no reason. I would also ask him if he truly believed everyone experienced periods of depression lasting weeks or months and on what basis did he believe this. I would ask suggestively if perhaps he had said so without believing it was true, only to appear or convince himself that it was normal. If I could get him to admit this was the case, I would probe more deeply into the incident of self-harm and try to discern whether he often had thoughts of harming himself during depressive episodes. I would ask him if he found his schoolwork to be more difficult during these periods of depression.

I do believe Danny only wanted to test drive the car and not steal it. First, he brought the car back after only a short time. Second, the thought and feeling he is describing are consistent with a delusion occurring during a typical manic phase. He was clearly acting on a distorted thought process. Criminal behavior, such as theft, during a manic phase, is often justified in the mind of the manic as something that is a necessary means to an end. The individual rationalizes that it is only “borrowing” because s/he will return the item(s) or money when everything works out according to plan. They believe that the action will ultimately produce no harm because they can fix it before anyone finds out or that if their actions were discovered, that their intentions will show that they meant no harm.

I would speculate that Danny’s symptoms and behavior are consistent with a diagnosis of Bipolar I Disorder. His parents’ observation of his only getting a few hours of sleep per night could be wrong. Danny may be in bed during that time but be fully awake, immersed in the “flight of ideas” so common in Bipolar I Disorder. Although Danny’s good grades have been consistent, this could be indicative of increased goal-directed behavior. Believing that the running car was a “golden opportunity” for him to experience something he otherwise could only dream about is indicative of grandiosity. It is not demonstrative of rational thinking or behavior. It is also indicative of engaging in activity with a high probability of negative consequences. He is experiencing a decreased need for sleep. Self-harm is not a usual response to adolescent infidelity. A depressive state, lasting for weeks or months, is not something that is experienced by everyone. The DSM-V states that there must be “[a] distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day” and the individual must exhibit 3 or more of 7 symptoms, which Danny clearly does –grandiosity, decreased need for sleep, and engage in high-risk behavior (American Psychiatric Association 2013).

To treat Danny for his Bipolar I Disorder, I would prescribe a combination of medications, including a mood stabilizer such as Lithium, an antidepressant such as Effexor, an anticonvulsant such as Topamax, and a low dose antipsychotic such as Abilify (M.U.S.E.). I would also refer him to a psychologist for Cognitive Behavioral Therapy to teach Danny how to deal with the symptoms, inhibit reversion to symptoms, and learn coping skills for managing feelings and tension (Watt, 2016). I would also recommend that Danny attend a peer support group so that he could discuss his experiences and relate to others like him. While drug therapy is an effective treatment, when used alone, it can fail because the individual often feels s/he is not sick and without any outside input, will often stop.

American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Retrieved from http://dsm.psychiatryonline.org.proxy.cecybrary.com/doi/full/10.1176/appi.books.9780890425596.dsm18

Colorado Technical University. (2013). Bipolar and related disorders. [MUSE]. Retrieved from Colorado Technical University Virtual Campus, PSY337-1702A-01: https://class.ctuonline.edu/_layouts/MUSEViewer/Asset.aspx?MID=7395875&aid=7395879

Watt, A. (2016) Cognitive Behavioral Therapy Retreived from: http://www.healthline.com/health/bipolar-disorder/cognitive-behavioral-therapy

Antisocial personality disorder

Antisocial Personality Disorder is a ubiquitous display of indifference to the rights of others, occurring in individuals at or beyond the age of majority, with evidence of conduct disorder before 15 years of age and where antisocial behaviors are not attributed to schizophrenia. Symptoms include deceitfulness, manipulation, impulsivity, irritability or aggression, persistent violations of the rights of others, careless neglect of one’s safety or the safety of others, lack of responsibility, and absence of regret. Antisocial personality disorder was previously identified as psychopathy or sociopathy. It is important to note that, while the disorder is found in both sexes, it is predominate in males (American Psychiatric Association 2013).

A person with Antisocial Personality Disorder would vary in affect depending on his or her motives. If s/he were not in the process of trying to con someone, s/he would likely appear irritated or angry. However, since manipulation – for pleasure or monetary gain – is a feature of the disorder, s/he will possess a falsely charming demeanor and be able to win people over, even people s/he had conned in the past. S/he will also steal or use money or personal items belonging to another person and is likely to violate personal space. S/he will have no personal boundaries and no respect for anyone else’s. Since the individual is only capable of superficial relationships, loyalty is very important to the individual and s/he will use callous or even cruel tactics to test loyalty because s/he is constantly questioning the bonds of others people to him or her. S/he finds humor in creating hazardous or dangerous situations while in the company of others because s/he has no regard for his or her own, nor anyone else’s, safety (Barlow D. & Durand M. Pg 454). In high school, I dated a man who was 19 – 21 through the time we dated. He was diagnosed as a sociopath at age 12, in 1986, but would likely have been diagnosed with Oppositional Defiant Disorder today, followed by a diagnosis of Antisocial Personality Disorder once he reached adulthood. He began stealing from his mother’s purse and breaking into people’s homes through open windows at age 7, was constantly in trouble at school because he didn’t listen to teachers and fought all of the time. By his admission, he laughed at a little girl with cancer, stole a homeless man’s shoes, and participated in the gang rape of an unconscious girl at a party. He told me these things to test my loyalty. When we were in the car, he would remove his hands from the steering wheel and suggest that if I didn’t take over, he would allow us to crash and die. He cheated on me with my best friend and two other women, the last one while I was unable to have intercourse due to Pelvic Inflammatory Disease and contracted HIV from her because they had unprotected sex even though they had just met. I do not know where he is now, but I heard that he had succumbed to AIDS, which would mean he did not make it to age forty. This is merely a short list of examples I could furnish to describe the disorder in him.

I believe the media has sensationalized this often misunderstood disorder, as Charles Manson or Jeffrey Dahmer are the most well-known archetypes of the disorder, while the average (and this term is used in the loosest of all possible ways) person with Antisocial Personality Disorder is not a mass murderer or conspirator to mass murder, but instead a liar, a thief, and a gargantuan disappointment to anyone who dares to care about him or her. An excellent example of the sensationalized archetype of Antisocial Personality Disorder is Patrick Bateman, the psychopathic murderer in Bret Easton Ellis’ Novel “American Psycho”. The character is a metaphorical representation of the author’s father and himself, a man in his 20s struggling with his identity (Grow, 2016). Both the novel and film are full of cues indicating that all of the gruesome, heinous acts committed by Bateman are a figment of his imagination (unnoticed blood trails, a real estate agent with no knowledge of the supposed murders committed by him in a condo of a colleague who disappeared, but was suspected to be abroad) (Robinson 2014).

I think the DSM-5 has placed Oppositional Defiant Disorder, Conduct Disorder, Antisocial Personality Disorder, Kleptomania, and Pyromania into a chapter called Disruptive, Impulse-Control, and Conduct Disorders because of all of the latter feature disruption, lack of impulse control and poor conduct. This is explained in the first paragraph of the section entitled Disruptive, Impulse-Control and conduct disorders, including the reason Antisocial Personality Disorder is listed in the chapter, while diagnostic criteria remain cataloged in the section for personality disorders (American Psychiatric Association 2013).

American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Retrieved from http://dsm.psychiatryonline.org.proxy.cecybrary.com/doi/full/10.1176/appi.books.9780890425596.dsm18

Barlow, D. & Durand M. 2014. Abnormal Psychology: An Integrative Approach. Retrieved from: https://online.vitalsource.com/#/books/9781285755618/cfi/114

Grow, K. 2016. ‘American Psycho’ at 25: Bret Easton Ellis on Patrick Bateman’s Legacy. Rolling Stone. Retrieved from: http://www.rollingstone.com/culture/news/american-psycho-at-25-bret-easton-ellis-on-patrick-batemans-legacy-20160331

Robinson, T. 2014. The Reality of American Psycho Isn’t as Compelling as the Conversation. Dissolve. Retrieved from: https://thedissolve.com/features/movie-of-the-week/515-the-reality-of-american-psycho-isnt-as-compelling-/

Bipolar II disorder

For an identification of bipolar II disorder, it is essential to see the subsequent criteria for a present or earlier hypomanic event and the subsequent criteria for a present or previous major depressive episode. A clear stage of oddly, plus assiduously heightened, extensive, ill-tempered disposition, along with abnormally and persistently increased pursuits plus vitality, continuing a minimum of 4 successive days and existing throughout the day, almost each day. During the phase of affect disruption, plus amplified drive and occupation, at least three of the subsequent indicators have continued (four if the state is only petulant), signify a perceptible alteration from typical conduct, and have been existent to a substantial level:

  1. Magnified self-worth or magnificence.
  2. Reduced requirement for rest.
  3. Extra loquacious beyond what is normal for the individual.
  4. A flurry of thoughts or personal observance of rushing concepts.
  5. Distractibility (i.e., attentiveness simply attracted to insignificant or unconnected outward motivations), as described or detected.
  6. Upsurge in objective focused pursuit or disruption of physical and mental activity.
  7. Disproportionate immersion in undertakings that have a high probability for destructive penalties

 the occurrence is connected with an unambiguous alteration in performance that is atypical of the person when not symptomatic.

 the disruption in disposition and the variation in functioning are apparent to others.

 the event is not severe enough to trigger distinct deficiency in public or professional performance or to require institutionalization. If there are psychotic qualities, the occurrence is, by classification, manic.

 the incidence is not caused by the corporeal effects of a substance (or separate medical condition.

 Five (or more) of the subsequent indicators have been existent within the congruent 2-week period and signify a variation from prior performance; at minimum one of the indications is either (1) dejected state or (2) lack of concern or gratification.

  1. Miserable disposition throughout each day, most days, as specified by either personal account or perception of others.
  2. Distinctly reduced concentration or gratification in every, or nearly every, pursuit throughout the day, almost daily (as indicated by either personal report or surveillance).
  3. Substantially reduced body mass without limiting diet or increased body mass, or diminished or heightened hunger each day.
  4. Difficulty or excessive sleeping each day.
  5. Distress or hindered physical and mental activity each day
  6. Lethargy or lack of drive each day.
  7. Thoughts of inadequacy or extreme or unfitting self-reproach each day
  8. Decreased capacity to reason or focus, or uncertainty, each day
  9. Persistent preoccupation with death, frequent suicidal ideation without a definite plan, a suicide attempt, or a particular strategy for committing suicide. (American Psychiatric Association 2013)

An individual in the hypomanic phase of the illness may appear intensely focused or wild-eyed. S/he will move and/or talk rapidly and at times be incoherent. S/he will talk extensively about grandiose plans to improve or enhance his or her life and of things s/he will do for people in his or her life. S/he will assume massive responsibilities, believing s/he can accomplish anything. The individual will feel and appear elated and seem ultra capable or hyper creative. S/he may stop taking prescribed medications, believing that s/he has become well. As the hypomanic phase spirals out of control and the consequences of taking on too much begin to accumulate, the individual becomes increasingly agitated and irritable and depression begins to overwhelm him or her. At this point, the individual drops any and all obligations, beginning to isolate and indulge in hypersomnia.

Impact on workplace performance can vary with the presence of either a depressed or hypomanic state. In a depressive state, the individual might exhibit reduced performance in required tasks and/or take a lot of “sick” days. During a hypomanic episode the individual may exhibit increased performance, although the quality of the work may suffer because of the frantic nature applied to activities. The individual is also likely to take on new and additional responsibilities, particularly financial aspects of the business and as the hypomanic state spirals out of control into the inevitable depressive crash, performance will suffer and the individual may commit theft of resources ranging from petty to grand larceny, depending upon the size of the financial responsibility.

Effective treatment can include Cognitive Behavioral Therapy (CBT) and prescribed antidepressants, mood stabilizers, anti-seizure medications and antipsychotics. When this course of treatment is followed, the individual can experience near normal-to-normal functioning (M.U.S.E. via American Psychiatric Association, 2013, p. 123).

In my experience, the long-term prognosis is poor. Individuals rarely adhere to medication regimens for more than a few years at a time and thus, experience periodic relapses, in which the symptoms of the illness reemerge as strongly as before treatment. All of my observations, with the exception of the beginning section (paraphrased from the Diagnostic and Statistical Manual for Mental Disorder, Edition 5) are obtained from personal experiences with relatives who have been diagnosed with the disorder and from my own personal experiences with the potential existence of the disorder within myself.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (Revised 5th ed.). Washington, DC: Author. Retrieved from http://dsm.psychiatryonline.org.proxy.cecybrary.com/doi/full/10.1176/appi.books.9780890425596.dsm03

CEC (2013). M.U.S.E. (My Unique Student Experience). Retrieved from https://class.ctuonline.edu/_layouts/MUSEViewer/Asset.aspx?MID=7395875&aid=7395879

Panic disorder

Panic disorder is characterized by chronic unanticipated panic attacks. A panic attack is a sudden rush of extreme fear or powerful distress accompanied by a minimum of 4 of the following 13 symptoms: heart palpitations or other heart function irregularities, perspiring, quivering or shuddering, feelings of being out of breath or asphyxiating, gagging sensations, aching chest, queasiness, vertigo, polar body temperature sensations, numbness or tingling, illusoriness or detachment, fear of losing control or going out of one’s mind, or fear of dying (American Psychiatric Association 2013).

A person with anxiety disorder might appear physically rigid or awkward, with a twisted, blank, stern, intense or fearful expression. This appearance would be the result of an attempt to contain the experience of the symptoms mentioned above. Other visible presentations might include shaking, fidgeting, lip biting, nail biting, excoriation, cutting or rocking. These behaviors would be an attempt, conscious or unconscious, to self soothe or calm the anxiety. They are maladaptive and present a variety of issues, including physical problems such as pain or discomfort and even infection, from the wounds created by the habits (Personal observation and experience 2011-2017).

Other maladaptive behaviors might include sensitization, safety behaviors, anxious avoidance, selective mutism, and escape. In sensitization, the individual seeks to learn about the feared place or situation and mentally rehearse the visit or event. Safety behaviors include insisting on being accompanied by a person with whom one feels “safe”, refusal to drive without being in contact with a safe person, and carrying anxiety medication at all times. The most common coping mechanism is anxious avoidance, in which the individual opts not to deal with the feared person, place or situation. Selective mutism involves being non-communicative in the situation, which is a behavior seen most in children, but can occur in adults, such as myself. Sadly, this coping mechanism is commonly interpreted as one being snobbish and can result in the individual being socially ostracized, which reinforces the anxiety about social interaction. With “escape” the individual actively seeks a literal escape route from the place or situation. This often results in hyper-vigilance, as the individual seeks comprehensive awareness of the place or situation. Unfortunately, all of these behaviors serve to reinforce the anxiety and further interfere with an individual’s ability to function (Jacofsky, Santos, Khemlani-Patel, and Neziroglu 2013).

According to Barlow and Durand , an estimated 2.7% of the populace will exhibit the symptoms to fulfill criteria for a diagnosis of panic disorder, in a one-year period, as will 4.7% at “some point in their lives” (2014 p 136). This is considered to be a fairly common occurrence. Interestingly, although Panic Disorder found worldwide, it is more common in in the United States and Some European countries, than in Latin, Asian, or African countries. This is also true among the associated races (APA 2013).

The potential impact on workplace performance is that it could be disruptive, both to the individual and to other workers. There is an increased potential for computer, typographical, or filing errors in an office setting and a heightened risk for accidents in an industrial setting.

One type of treatment that seems to be effective is a combination of daily Selective Serotonin Re Uptake Inhibitors (SSRIs) and Benzodiazepines, as needed, for acute symptoms, along with cognitive therapy. Therapeutic treatments involve controlled exposure to the object of fear. These methods range from the therapist accompanying the patient to prescribed drills. These combined with healthy coping mechanisms such as relaxation through breathing or isometric exercises have proven successful, in many cases. Although study findings initially showed little difference between individuals being treated only with medication and those being treated with medication along with psychotherapy, after 6 months the latter demonstrated marked improvement over their counterparts (Barlow and Durand 2014 p 141).

The prognosis for those treated for panic disorder is fairly positive, with supplemental studies showing sustained improvement in the majority of participants, after two years. Nevertheless, some individuals experienced a recurrence of symptoms, which led psychologists to develop the concept of “booster treatments”(Barlow and Durand 2014). This involved 9 months of monthly visits, after the initial 3-month treatment (Barlow and Durand 2014).

Barlow D./Durand M. (2014). Abnormal Psychology: An Integrative Approach. Cengage Learning Retrieved from https://online.vitalsource.com/ – /books/9781285755618

American Psychiatric Association. (2013). Diagnostic and Statistical Manual Fifth Edition Retrieved from http://dsm.psychiatryonline.org.proxy.cecybrary.com/doi/book/10.1176/appi.books.9780890425596

Jacofsky, M., Santos, M., Khemlani-Patel S, Neziroglu (2013) The Maintenance Of Anxiety Disorders: Maladaptive Coping Strategies Retreived from The Bio Behavioral Institutehttps://www.mentalhelp.net/articles/the-maintenance-of-anxiety-disorders-maladaptive-coping-strategies/

Body dysmorphic disorder

Body Dysmorphic Disorder (BDD) is characterized by an obsession with one or more perceived flaws in certain aspects of the individual’s appearance and the pervasive repetition of specific actions, such as checking one’s reflection or preening, or thought processes, such as comparing the feature(s) to that of others. The alleged defects are unnoticeable or minor, as viewed by others. The most commonly scrutinized areas are the skin, hair, or nose. The issue must result in significant dysfunction in order to meet criterion (American Psychiatric Association, 2011, para, 1). Efforts to alter the appearance of the flaw may vary from minor, such as a particular type or size of clothing or accessory, to cosmetic surgery or even self-mutilation. Although the individual may seek to remedy the feature(s), s/he will likely be dissatisfied with the result. This is due to the perceived nature of the flaw. The feature changes but the perception remains the same (Cengage Learning, 2014, p. 171).

Although BDD is often dismissed as a ‘first world problem’, according to both the British Broadcast Corporation (BBC) and Hanna McLean of the European Journalism Centre (EJC), it is a worldwide problem, even where access to the media is limited or non existent (McLean, EJC, 2011) (BBC, 2015). Both of these articles indicate solemnness, which is indicative of an unbiased approach to covering the topic. The BBC article cites a Dr. Veale, who proclaims there is a fine line between poor self-image and BDD, then goes on to say it is “earlier life events such as poor child-mother attachment and bullying that are more significant” (BBC, 2015). While media influence is certainly a factor, as an anonymous American blogger told the BBC author, “[e]very day, every hour, every minute, everywhere I turn, there are thin people…In magazines, they are there, posed like a Barbie, their picture of beauty forever frozen in time…The answer, I’ve found, is no. No, you’re never going to think you’re thin enough. No, you’ll never see yourself as beautiful”, specific causation is difficult to track because many individuals develop BDD independently of influence from the media (BBC, 2015).

After reading chapter 5, in “Abnormal Psychology: an Integrative Approach” and the section Obsessive-Compulsive and Related Disorders, in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V); it is apparent to me that these disorders that have been previously classified separately have now been grouped together because the symptoms of each are obsessive-compulsive in nature. The DSM-V characterizes obsession as invasive and undesirable thoughts or images that are pervasive and repetitive and compulsion as cyclic actions or thought patterns that one is compelled to perform, in order to relieve pressures of an obsession. These definitions can be easily applied to or are in some cases comorbid with Obsessive-Compulsive Disorder. Hair pulling (trichotillomania), skin picking (excoriation), and hoarding because of the fear of needing something that has been discarded, along with BDD-associated behaviors such as mirror checking are all obsessive-compulsive. Therefore, it is logical that they should be categorized under one heading.

Barlow D./Durand M. (2014). Abnormal Psychology: An Integrative Approach. Cengage Learning https://online.vitalsource.com/ – /books/9781285755618

American Psychiatric Association. (2013). Diagnostic and Statistical Manual Fifth Edition http://dsm.psychiatryonline.org.proxy.cecybrary.com/doi/book/10.1176/appi.books.9780890425596

McLean, H. (2011). Body Dysmorphic Disorder: Does media play a role?. European Journalism Centre. Retrieved from http://ejc.net/magazine/article/body-dysmorphic-disorder-does-media-play-a-role - .WPQDsoUdIpl
BBC (2015). The 'ugly truth' about Body Dysmorphic Disorder Retrieved from: http://www.bbc.com/news/health-33190297

Who has the right-of-way – – right or left turn?

From Google search;
THE GENERAL LEFT TURN LAWS: Left turns shall yield to oncoming traffic. The driver reaching the intersection first has the right-of-way unless turning left. When two vehicles reach the intersection simultaneously, the one on the right has the right-of-way.

A vehicle turned left in front of me, in my bank parking lot and I said wtf. So this male chauvinist idiot pig accosted me at my car, in the ATM, to “correct me”. I screamed for him to get the fuck away from me to get security involved because he threatened to beat me up.

He is a Filipino immigrant and their r.o.w. Laws may be different, but when you come to the US, you are bound by our laws, just as in any other countries.