Treating Patients With Impulsivity
Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction Impulsivity, compulsivity, and addiction are challenging disorders for patients across the life span. Impulsivity is the inclination to act upon sudden urges or desires without considering potential consequences; patients often describe impulsivity as living in the present moment without regard to the future (MentalHelp.net, n.d.). Thus, these disorders often manifest as negative behaviors, resulting in adverse outcomes for patients. For example, compulsivity represents a behavior that an individual feels driven to perform to relieve anxiety (MentalHelp.net, n.d.). The presence of these behaviors often results in addiction, which represents the process of the transition from impulsive to compulsive behavior. In your role as the psychiatric nurse practitioner (PNP), you have the opportunity to help patients address underlying causes of the disorders and overcome these behaviors. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with impulsivity, compulsivity, and addiction. Reference: MentalHelp.net. (n.d.). Impaired decision-making, impulsivity, and compulsivity: Addictions’ effect on the cerebral cortex. https://www.mentalhelp.net/addiction/impulsivity-and-compulsivity-addictions-effect-on-the-cerebral-cortex/ To prepare for this Assignment: Review this week’s Learning Resources, including the Medication Resources indicated for this week. Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring therapy for impulsivity, compulsivity, and addiction. The Assignment: 5 pages *****Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. ******BELOW IS THE LINK TO THE CASE STUDY https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/DT/week_08/index.html At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. ******Introduction to the case Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision-making when prescribing medication for this patient. *****Decision #1 (1 page) -Which decision did you select? -Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. -Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. -What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). -Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. *******Decision #2 -Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. -Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. -What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). -Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. *******Decision #3 -Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. -Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. -What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). -Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. ******Conclusion -Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. ****Note: Support your rationale with a minimum of SIX academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. ***PLEASE THIS IS MY LAST ASSIGNMENT FOR THE CLASS. THIS PROFESSOR IS SO THOUGH THAT THE HIGHEST GRADE SHE HAS GIVEN ME WAS 76.50 IN THESE ASSIGNMENT.S. PLEASE MAKE IT GOOD< ANSWER ALL PARTS> SHE SAID IF ALL QUESTIONS ARE ANSWERED ACCORDING< TO THE POINT. WE ARE NOT SUPPOSED TO PLAY AROUND TO SEE WHAT DECISION IS BEST. TO RESEARCH THE MEDICATIONS ASED ON THE CASE AND SYMPTOMS< THEN MAKE A DECISION AND DEFEND OUR DECISION. I AM TRUSTING YOU PLEASE!!! THANK YOU FOR YOUR HARD WORK. Learning Resources for NURS 6630 Required Readings (click to expand/reduce) Kelly, J. E., & Renner, J. A. (2016). Alcohol-Related disorders. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier. Renner, J. A., & Ward, N. (2016). Drug addiction. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier. Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders: Treatment improvement protocol series, no. 32. https://www.ncbi.nlm.nih.gov/books/NBK64350/ Chapter 1, “Substance Use Among Adolescents” Chapter 2, “Tailoring Treatment to the Adolescent’s Problem” Chapter 7, “Youths with Distinctive Treatment Needs” University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control. Journal of Psychosocial Nursing & Mental Health Services, 54(4), 15. Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical Pharmacology, 77(2), 375–381. https://doi.org/10.1111/j.1365-2125.2012.04457.x Hulvershorn, L. A., Schroeder, K. M., Wink, L. K., Erickson, C. A., & McDougle, C. J. (2015). Psychopharmacologic treatment of children prenatally exposed to drugs of abuse. Human Psychopharmacology, 30(3), 164–172. https://doi.org/10.1002/hup.2467 Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10–15. https://doi.org/10.3928/00989134-20160314-04 Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual Diagnosis, 8(1), 74–84. https://doi.org/10.1080/15504263.2012.648439 Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., Olvera, R., Swann, A. C., & Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive Psychiatry, 55(6), 1337–1341. https://doi.org/10.1016/j.comppsych.2014.04.018 Medication Resources (click to expand/reduce) U.S. Food & Drug Administration. (n.d.). Drugs@FDA: FDA-approved drugs. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm
of mind to one excluding mental, we deduct the importance of experience in understanding a phenomenon. Jackson explains that “mental states are inefficacious in respect to the physical world” (Jackson). Qualia only impact other mental states rather than physical states. Jackson reiterates this by providing three reasons. The first being causality. Just because A follows B does not mean B can follow A. The B follows A hypothesis can be refuted by proving there is a common underlying causal process for each distinct effect. Second, Jackson uses evolution to prove his dualism. Polar bears have evolved to have a thick coat. This thickness makes the coat heavy. Thus, the polar bears experience what it is like to carry a heavy coat. This is clearly not conducive to survival. Therefore, from Darwin’s Theory we know that any evolved characteristics are either conducive to survival or a by-product of an evolutionary action that is conducive to survival. Jackson uses this support his argument against physicalism: “qualia are a by-product of certain brain processes that are conducive to survival” (Jackson). Third, Jackson emphasizes the relationships between how we know our minds through behavior. We only know about others’ minds through observing their behavior. So, we must ask: how can a person’s behavior accurately reflect that he has qualia unless they conclude that behavior is an outcome of qualia? This gives rise to the main weakness of Jackson’s view – there is no proper evidence for the refutation of epiphenomenal qualia. Another weakness of Jackson’s view is the lack of clarity of source. Where do these qualia come from? If not physical, then where? This brings into questions spirits and “upper powers,” such as God, the existence of which are heavily debated in the scientific community. Despite this, the validity of dualism (and the lack of proving dualism to be incorrect), is a strong argument and will continue to allow Jackson’s argument to be considered valid. Because Jackson clearly refutes any existence of physicalism in his explanation of phenomenal qualia, and his argument is overall less problematic than the arguments of his opponents, I align more with Jackson’s knowledge argument than that of Lewis. Until the existence of the actual physical matter behind “what it is like” information is found, Jackson’s argument proves to be more valid than that of Lewis. Although I would like to think that everything involving humans can be linked back to the brain, I do believe that some things may never be explained.