Assignment: Patterns of brain activation
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Assignment: Patterns of brain activation and inhibition
A. Biological/Neurobiological
1. Research is limited; There are no known biological causes
2. Neuroimaging studies show patterns of brain activation and inhibition consistent with other dissociative disorders. Three consistent findings have emerged:
i. altered activation of posterior cortical sensory association areas, primarily the inferior parietal lobe Comment by Dr. Dumont: These should be lower-case letters
ii. prefrontal activation
iii. limbic inhibition
3. They highlight a neural mechanism common among dissociative disorders—prefrontal activation and limbic inhibition.
4. Suppression of emotion would plausibly inhibit the neural connectivity that would facilitate integration of information about memory, identity, and consciousness (Spiegel, Lewis-Fernández, Lanius, Vermetten, Simeon, & Friedman, 2013, p. 316). Comment by Dr. Dumont: For six or more authors, cite the primary author followed by ‘et al.’ for the first and all following mentions of the work (Chapter 6, 6.12, p. 175).
B. Life Events
1. Emotional, Physical, and Sexual Abuse
i. Survivors of chronic childhood abuse can suffer from problems in several developmental domains: Comment by Dr. Dumont: These should be lower-case letters
a. affect regulation Comment by Dr. Dumont: These should be lower case Roman numerals
b. interpersonal functioning
c. self-perception
d. cognition
e. impulse control
f. (Brand, Classen, McNary & Zaveri, 2009, p. 653).
2. Trauma in Early Childhood
i. Dissociative disorders (DD) prevail as sequelae to overwhelming experiences in childhood (Fine, 2012, p. 333). Comment by Dr. Dumont: These should be lower-case letters
3. Combat
i. Discuss the overlap of misdiagnosing DD for PTSD Comment by Dr. Dumont: These should be lower-case letters
4. Natural Disasters
5. Loss of a Loved One
V. EVALUATING FOR THESE DISORDERS
A. It would be beneficial to use a systematic assessment tools such as structured interviews to document in a laborious way Axis I and Axis II diagnoses
B. Standardized measures to assess other areas of functioning within life
C. Measures to assess symptoms and overall functioning of the patient should be given at the beginning of treatment and readministered periodically so as to document the treatment progress Comment by Dr. Dumont: Nice work on including assessment tools in this section
D. (Aadil & Shoaib, 2017, p. 408).
VI. TREATMENT OPTIONS
A. Patients with dissociative disorder who integrated their dissociated self states were found to have reduced symptomatology compared with those who did not integrate (Brand, Classen, McNary & Zaveri, 2009, p. 646). Comment by Dr. Dumont: For three to five authors, cite all of the authors the first time the work is mentioned and the primary author followed by ‘et al.’ for all successive times the work is mentioned. (Chapter 6, 6.12, p. 175).
B. Treatment Options for individuals diagnosed with PTSD are similar to those diagnosed with DD. Patients diagnosed with DID, the most severe form of DD, have been shown to have the highest psychiatric costs among patients entitled to psychiatric disability payments in Massachusetts, which suggests there are also economic reasons for identifying effective treatments for this population (Brand, Classen, McNary, and Zaveri, 2009, p. 649). Comment by Dr. Dumont: For three to five authors, cite all of the authors the first time the work is mentioned and the primary author followed by ‘et al.’ for all successive times the work is mentioned. (Chapter 6, 6.12, p. 175).
C. Although there is a small but growing body of controlled trials examining treatments for adult survivors of child abuse, there are no controlled trials for the treatment of DD (Foote, B & Van Orden, 2016, p. 351). Comment by Dr. Dumont: Delete. Comment by Dr. Dumont: Good job on overview of the treatment options
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