1-Respond the other learners. Your response is expected to be substantive and to

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1-Respond the other learners. Your response is expected to be substantive and to reference the assigned readings, as well as other theoretical, empirical, or professional literature to support your views and writings. Reference your sources using standard APA guidelines.
1.1Yurigsa Mendoza
Nov 8, 2023Nov 8 at 11:18pm
Anorexia nervosa has both environmental and physical causes. Identify and discuss these two causes and what specific factors may be involved in both the physical and environmental roots of anorexia. Next, discuss how these two types of causes can inform the ethical treatment of this disorder.
Anorexia is a mental disorder in which a person is terrified of gaining weight, they are very skinny, and they are very conscious of their physical figure of not gaining weight. Anorexia is very scary because obviously it is not healthy, and it can cause secondary illnesses such as bone loss and weakness due to the lack of nutrients. The article I found talked about anorexia’s causes sociocultural and environmental (nature & nurture) both play a factor. Sociocultural is the influence in society that plays a role in people’s behavior. Environmental factors are genetics, our beliefs, feelings, and the people that surround us. There has also been a debate that anorexia is hereditary and is not impacted by society. “Heritability is defined as a proportion of the total variation in phenotypic traits between individuals in a specific population that is due to genetic difference” (Sirine et al, 2021). In the physical aspect, I can see how society can have an impact on anorexia because all the “hot girls” are skinny, social media portrays a perfect body as being a skinny girl. Social media is a huge trigger to people, especially those young teens who are trying to look attractive for their crush. It is so sad how little girls develop eating disorders to have perfect body’s back all of that affects their mental state as well. In the environmental aspect, if it is hereditary then you can see how anorexia affects offspring. The genetic contribution to anorexia was said to be a 28-83% hereditary rate and in developing anorexia there was a rate of 40-60% rate (Sirine et al, 2021). There were also some genes from the central nervous system that related to anorexia in this study. “The COMT enzyme is a methylation enzyme that is responsible for the metabolism and degradation of more than 60% of dopamine and other catechol amines in the brain, especially in the frontal cortex” (Sirine et al, 2021) The conclusion of this study was inconclusive in regards the gene factor because there are multiple factors in a mental illness and there are multiple origin causes of anorexia. Anorexic people control their calorie intake by vomiting or even taking laxatives to get rid of the calories they eat. “Not until nutrients are absorbed from the intestines can they be used to nourish the cells of the body and replenish the body’s nutrient reservoirs” (Carlson & Birkett, 2019). Since anorexia prevents the affected people from eating or keeping food in their stomach, it would be hard for their body to get nutrients, so they usually lack the nutrients and that is very damaging for their body. With the environmental and sociocultural factors of anorexia, this can help with ethical treatment by looking at the genetic factors, and if depression plays a role this person might need depression medications to help the anorexia illness. Some other approaches could be family therapy, medications, and even having a social group that can share their experiences can help others with anorexia because they will listen to other stories and how they had the same fear with weight, and this can help them feel better about themselves. “Researchers have tried to treat anorexia nervosa with many drugs that increase appetite in laboratory animals or in people without eating disorders” (Carlson & Birkett, 2019). I’ve worked in a clinic and our protocol was to not weigh anorexic patients because that would trigger their illness and that could make treatment fail.
Carlson, N. R., & Birkett, M. A. (2019). Foundations of Behavioral Neuroscience (10th ed.). Pearson Education (US). https://capella.vitalsource.com/books/9780134641362Links to an external site.
Sirine, A. A. H., Darren, C., & Lama, M. (2021). The impact of COMT, BDNF and 5-HTT brain-genes on the development of anorexia nervosa: a systematic review. Eating and Weight Disorders, 26(5), 1323-1344. https://doi.org/10.1007/s40519-020-00978-5Links to an external site.
1.2Affrica Mayes
Nov 11, 2023Nov 11 at 3:05am
Week 6 discussion

Anorexia nervosa is a complex eating disorder characterized by an intense fear of gaining weight and a distorted body image. Environmental and physical factors contribute to anorexia nervosa. Let’s take a closer look at the physical causes of anorexia nervosa. Research has shown that several biological factors contribute to the development of this disorder. According to Carlson and Birkett (2019), genetics is a significant factor. Studies have indicated that individuals with a family history of eating disorders are more likely to develop anorexia nervosa. This suggests that certain genetic predispositions may make some individuals more susceptible to the disease. Nervous system abnormalities are another physical cause of anorexia nervosa. A neurochemical imbalance and brain structure alteration associated with anorexia nervosa are known to affect appetite control, mood, and impulse control in individuals with the disease. Individuals with anorexia nervosa occasionally experience restrictive eating habits and distorted body image thoughts because of these abnormalities (Treasure et al., 2015).
Several factors can contribute to anorexia nervosa, including societal and cultural influences. Dissatisfaction with one’s body and disordered eating behavior can be influenced by the media, for example. The unrealistic beauty standards perpetuated by the media can lead to an idealized thin body image that individuals with anorexia nervosa strive to achieve. A traumatic life event, peer pressure, family dynamics, and family dynamics may also contribute to anorexia nervosa’s onset (Treasure et al., 2015). Understanding the relationship between physical and environmental factors is crucial in anorexia nervosa ethical treatment. Recognizing the involvement of genetic and neurobiological factors emphasizes the need for a multidimensional approach to treatment. This can include interventions like cognitive-behavioral therapy (CBT) and family-based therapy (FBT) to address both the psychological and physiological aspects of the disorder.
Body positivity and challenging societal beauty standards are vital in addressing environmental causes. To achieve this, media literacy programs can be implemented, and supportive environments that value diversity can be created. The ethical treatment of anorexia nervosa can also involve providing support to those who have experienced trauma and dealing with underlying emotional issues. Anorexia nervosa is a complex disorder with both psychological and environmental causes. The disorder’s physical symptoms result from genetic predispositions and neurobiological abnormalities.
On the other hand, environmental factors such as societal and cultural influences play a significant role in the development of the disorder. Therefore, it can be concluded that both physical and environmental factors contribute to the roots of anorexia nervosa. As a result of understanding the causes of these conditions, an ethical approach can be developed to treat them more comprehensively and holistically that considers both physical and environmental elements. To treat people with anorexia nervosa effectively and compassionately, we need to promote body positivity and provide appropriate support for those with this disorder (Treasure et al., 2015).
Affrica R. Mayes
Carlson, N. R., & Birkett, M. A. (2019). Foundations of behavioral neuroscience (10th ed.). Pearson Education (US). https://capella.vitalsource.com/books/9780134641362Links to an external site.
Treasure, J., Zipfel, S., Micali, N., Wade, T. D., Stice, E., Claudino, A. M., Schmidt, U., Frank, G., Bulik, C. M., & Wentz, E. (2015). Anorexia nervosa. Nature Reviews Disease Primers, 1(1). https://doi.org/10.1038/nrdp.2015.74Links to an external site.
2-Review the posts of other learners and respond to them. Evaluate their response with an eye to adding information to their discussion that fully describes the issues they have addressed.
2.1Raswinder Nagra
MondayNov 13 at 7:51pm
Substance use disorder, according to the DSM-5-TR, indicates that there are behavioral, cognitive, and physical symptoms that an individual who uses the substance will display even as there are negative outcomes in their functioning (American Psychiatric Association, 2022).
Abuse is noted as a mild or early phase, and dependence is noted as a more severe manifestation of the use of a substance. It was noted that revisions of DSM-5 combined abuse and dependence criteria into a single substance use disorder (Hasin et al., 2013).
According to the American Psychiatric Association (2022), generalized anxiety disorder would present with diagnostic criteria such as excessive worry and anxiety about both activities or events, such that they present for the majority of days over a six-month period. In addition, the individual must have difficulty controlling their worry, and its presentation affects social or occupational functioning. Furthermore, the DSM-5-TR requires 3 of the following six physical symptoms to meet the criteria for a generalized anxiety disorder: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance (American Psychiatric Association, 2022).
Generalized anxiety disorder and dependence on a substance would present as unsuccessful efforts to stop or reduce the substance use, craving of the substance leading to a great deal of time obtaining it, its use or recovery, functional impairment in social, occupational, or recreational activities due to substance use and its recurrent use even with impairment or physical hazards. In addition, tolerance and withdrawal would be noted by a need for increased levels of the substance to achieve intoxication (American Psychiatric Association, 2022).
Alongside the substance abuse presentation, which would include recent use of the substance and generalized anxiety disorder presented above, all these symptoms may be present depending on the substance discussed below. It would be important to note that the generalized anxiety disorder would be present even with the discontinuation of the substance of a month. This indicates that the anxiety disorder is not completely attributable to the physiological effects of the substance. This would indicate that the generalized anxiety disorder would be present even in contexts without the consumption of the substance.

Dependence on marijuana would present as euphoria, anxiety, the sensation of slowed time, impaired judgment, and social withdrawal, along with physical signs such as conjunctival injection, increased appetite, dry mouth, or tachycardia (American Psychiatric Association, 2022).
Alcohol intoxication would present with behavioral changes such as inappropriate behavioral or psychological changes (i.e. Anger, sexual advances) alongside slurred speech, incoordination, unsteady gait, nystagmus, impairment in attention or memory, and stupor or coma.
Cocaine intoxication would also present with behavioral or psychological behavioral changes, including euphoria, changes in social behavior, interpersonal sensitivity, anxiety, tension or anger, and impaired judgment. In addition, after its use, there may be changes in blood pressure, heart rate, pupil dilation, chills or sweating, nausea, psychomotor changes, weight loss, muscle weakness, chest pains, cardiac arrhythmias, or even respiratory depression (American Psychiatric Association, 2022).
Methamphetamines would present as a similar outcome to cocaine as a stimulant and amphetamine.

Diathesis – stress issues must evaluate the person’s vulnerability, predisposition, and stressors that can activate the response. For example, we must evaluate that stressors may present physically and psychosocially and the signs and symptoms with underlying predispositions, current physical and psychosocial conditions, and stressors (Jung, 2023).
According to Iwamoto et al. (2011), a review of substance use among Asian American women explored the role of depression, coping, and peer use with Asian values. It is presented that depression and substance use is to cope with psychological issues. This is supported by Asian American high school students with depression related to alcohol use. In addition, peer use is predictive of personal use as it shapes peer group behavior, values, and attitudes. It is noted that Asian ethnic groups share cultural values and beliefs, primarily collectivism, filial piety, conformity to norms, deference to authority, humility, hierarchical relationships, family recognition, and emotional control (Iwamoto et al., 2011). Depressive symptoms were found to be directly related to illicit drug use and alcohol consumption in Asian college women but not binge drinking. It was noted that Asian values did not serve as a protective factor against alcohol consumption, binge drinking, or illicit drug use. The researchers speculate that the women in distress may be overwhelmed, and this coping allows distraction versus turning inward to their cultural values and worldview. There was no difference between active or avoidant coping styles and substance use among Asian women. It is also important to note that peer use is a very strong factor in substance use.

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787Links to an external site.
Jung, N. (2023). Psy6210: Week 2 Overview: The building blocks of diagnosis: interviewing, history and collateral sources. Department of Capella University. https://campus.capella.edu/homee | Capella University
Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., Compton, W. M., Crowley, T., Ling, W., Petry, N. M., Schuckit, M., & Grant, B. F. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. The American Journal of Psychiatry, 170(8), 834-851. https://doi.org/10.1176/appi.ajp.2013.12060782Links to an external site.
Iwamoto, D. K., Grivel, M., Cheng, A., Clinton, L., & Kaya, A. (2016). Asian american women and alcohol-related problems: The role of multidimensional feminine norms. Journal of Immigrant and Minority Health, 18(2), 360-368. https://doi.org/10.1007/s10903-015-0159-3
2.2Najeem Atinsola
TuesdayNov 14 at 12:30am
Substance Use (Abuse and Dependence)
Regular use of psychoactive substances, such as alcohol or opioids, can induce substantial alterations in an individual’s mental, behavioral, and physical well-being. It encompasses a range of behaviors, from sporadic occurrences to consistent patterns and even normative behaviors. Substance abuse is characterized by a constant and detrimental way of substance utilization, leading to impairment or distress across all aspects of functioning (First et al., 2023). This disability may manifest in various domains, including work, educational settings, and interpersonal connections. It often involves repeated exposure to potentially harmful situations and suggests a failure to fulfill significant role responsibilities.
Substance dependency, or substance use disorder (SUD) as it is referred to in the DSM-5-TR, is a more severe and chronic form of engagement with drugs or alcohol. It is characterized by a constellation of mental and physical signs that the user keeps drinking or using drugs despite adverse consequences. Tolerance, withdrawal, and unsuccessful attempts to reduce or regulate use are used to make a diagnosis of dependence.
The symptoms of someone with both GAD and alcohol dependency may be challenging to distinguish from one another. Because some people with anxiety disorders turn to drinking as a means of self-medicating their problems, this condition may raise their risk of developing an alcohol use disorder. Anxiety, concern, restlessness, and bodily manifestations like muscle tightness could all be present. Due to alcohol’s ability to momentarily relieve anxiety symptoms, the clinical picture may be clouded when GAD and alcohol dependency co-occur. Anxiety symptoms can be made worse by the impairment brought on by alcoholism, producing a cycle between the two conditions.
Certain cultural groups may be more at risk for substance misuse due to a higher prevalence of genetic or environmental factors (diathesis). Additionally, stresses, including prejudice, acculturation difficulties, and socioeconomic gaps, may amplify the danger. This problem emphasizes the need to consider cultural factors when designing prevention and treatment strategies. Culturally sensitive therapies that target both the diathesis and stress components may be more effective than a blanket approach. Including multiple cultural perspectives on substance use in effective prevention and treatment programs is critical.
First, M. B., Clarke, D. E., Yousif, L., Eng, A. M., Gogtay, N., & Appelbaum, P. S. (2023). DSM-5-TR: rationale, process, and overview of changes. Psychiatric Services, 74(8), 869-875. https://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.20220334Links to an external site.
3.Review the posts of your peers, and respond In each case, identify at least one insight into diagnostic issues that your peer has identified that you did not. Evaluate that insight, and explain your reasons for agreeing or disagreeing with its applicability in this case.
3.1Raswinder Nagra
Nov 12, 2023Nov 12 at 11:13pm
Diagnostic possibilities that Ben’s case presents include delirium and a major neurocognitive disorder. The case history supports a diagnosis of delirium as it meets the criteria for which it requires an acute impairment of consciousness with a reduction in awareness and attention. In addition, it requires that these deficits are accompanied by changes from baseline that are not explained by a pre-existing neurocognitive disorder (American Psychiatric Association, 2022). It is reported that Ben’s disturbance has developed over the preceding five days, which is a short period of time, meeting Criterion B. It is noted that Ben exhibits impairments in language, social cognition, and executive functioning, fulfilling criterion C for delirium. The difficulty with incomplete medical records post-car accident indicates that Criterion D, that disturbances in attention, awareness, and cognition are not better explained by another pre-existing, established, or evolving neurocognitive disorder at this time. Criterion E notes that delirium would be a direct physiological consequence of another medical condition, substance use or withdrawal, toxin exposure, or due to multiple etiologies (American Psychiatric Association).
To interview for the possibility of delirium, we would need to determine if the client has any medical conditions or substance use that may not be revealed to Cindy. This would require further medical assessment, such as a toxicology screening and lab work to determine if Ben meets criterion E. If it is noted that Ben presents with a medical issue or neurological changes such as HIV, substance intoxication, or withdrawal, this will allow for a diagnosis of delirium. Possible answers that may lead me away from delirium include a clean medical work up, including no substances within the body or inconclusive blood tests.
To determine a diagnosis of adjustment disorders, as it is noted that this includes the development of emotional or behavioral symptoms in response to a stressor, such as Ben noted extreme work stress in his interview. The behaviors are significant, such as we can support impairment in social, financial, and occupational functioning, and the marked distress is out of proportion to the severity of the stressor. In addition, the stress-related disturbance does not meet the criteria for other mental illnesses or bereavement. In addition, the functional consequences of this disorder would support the changes in his social and work relationships. This can all be supported due to a rapid change in behavioral and emotional symptoms such as leaving the car running while taking the bus, irritability in the interview, and inappropriate conduct with the neighbor at the party. A series of questions that would need to be asked would be an evaluation with his boss to determine if work stress has increased and changes in performance at work. In addition, I would interview colleagues and his boss to determine if this has previously been noted with other work stress in the past. If the boss and colleagues are not able to corroborate a significant stressor at work, then this would cause us to remove this diagnosis. However, if there are large changes in the company, such as downsizing rumors or changes in personnel and management that are new that Cindy may not have been aware of, and the medical records indicate a clean medical history with no neurological changes, we would provide adjustment disorder as a diagnosis.
To further clarify Ben’s diagnosis, this requires further medical assessment and review of medical records post-car accident. I would also highly recommend neurological testing, including a Mini–Mental State Examination, an EEG, brain CT, and T2-weighted brain MRI scans to assess for evidence of structural brain damage (Barnhill, 2023). I would also require a further study of his medical records post-accident and request all insurance records to corroborate any records of post-traumatic amnesia, disorientation, or neurological signs that were noted.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787Links to an external site.
Barnhill, J. (Ed.). (2023). DSM-5-TR Clinical Cases. American Psychiatric Association Publishing
First, M.B. (2014). DSM-5 Handbook of Differential Diagnosis. American Psychiatric Publishing.
3.2Sherry Murphy
TuesdayNov 14 at 4:08pm
What diagnostic possibilities does Ben’s case present?
What have you read in the case history so far that presents these possibilities for you?
There are various diagnostic possibilities at this point. There are way more questions than answers. It seems as if it would be impossible at this point with this little information to diagnose accurately. They possibilities at this point are as follows:
A possible mood disorder such as bipolar disorder because Ben’s mood swings, irritability, and inappropriate behavior are suggestive a mood disorder, such as major depressive disorder or bipolar disorder.
It is possible there is a substance use disorder because Ben’s change in behavior, irritability, and the mention of alcohol use at the party and nightly raise the possibility of substance use disorders.
Possibly a trauma or stressor-related disorder or a TBI because the auto accident, head injury, and recent work stress may contribute to symptoms indicative of a stress-related disorder.
A possible neurocognitive disorder because of Ben’s cognitive difficulties, such as disorganization, eating with fingers, and the incident with the car, may suggest a neurocognitive disorder, possibly related to the head injury.
Perhaps it is a personality disorder because of Ben’s sudden and complete change in behavior, vernacular, lecherous comments, and aggressive actions may hint at a personality disorder.
What kind of questions you might ask to evaluate each diagnostic possibility? You must consider at least two, but no more than three, diagnostic possibilities, and develop a series of questions to interview for each possibility.
To evaluate the possibility of a mood disorders I would explore Ben’s mood over the past few months, dating back at least one year, then go back over more time and even divulging as far back as his teenage years to explore earlier signs of mood fluctuations. With bipolar disorder only one manic episode (which can attribute to Ben’s symptomology) is necessary for the disorder. I would inquire about changes in sleep patterns, energy levels, and interest in activities as well.
To uncover if there are any neurocognitive disorders I would attempt to examine cognitive functions, memory, and attention. Additionally, I would inquire about any other cognitive changes since the head injury. It seems as if he is disorganized in his thinking forgetting who I am asking why I am present when he is the one in the hospital for an evaluation. Furthermore, he was disorganized in thinking because he had been having difficulty organizing his briefcase as well as going off and leaving the car running and taking the bus.
In terms of personality disorders I would explore Ben’s interpersonal relationships over time and any patterns of problematic behavior. Of course, I would seek informed consent before interviewing others in his life. I would investigate if these behaviors are long-standing or recent.
What possible answers would lead you toward or away from each of your possibilities?
Answers of Confirmation
Answers of a negative confirmation
Mood Disorder

Consistent reports of persistent low mood, loss of interest, changes in sleep and appetite.

Evidence of impaired daily functioning due to mood symptoms.
No significant changes in mood or interest in usual activities.
Mood fluctuations are situational and tied to specific stressors.
Neurocognitive Disorder
Observable cognitive deficits, such as memory loss or difficulty with tasks.

Reports of significant cognitive decline since the head injury.
No apparent cognitive deficits in daily functioning.

Cognitive difficulties can be attributed to stress or other factors.
Personality Disorder
Consistent history of problematic interpersonal relationships.

Patterns of inappropriate behavior that extend over a significant period.
Recent and isolated incidents of inappropriate behavior.

Behaviors are situational and not reflective of longstanding patterns.

What further information and referrals would you want to clarify Ben’s diagnosis?
I would like to have a comprehensive medical history including any recent illnesses or changes in physical health. More detailed information on Ben’s general health, including recent check-ups and screenings.
I would like a detailed history and further like to dig into his psychosocial history asking for more details of Ben’s social relationships, both current and historical. It would be beneficial to note any significant life events, losses, or changes in the past year that may contribute to his current state.
A full formal cognitive assessment would be helpful to objectively evaluate memory, attention, and executive functioning. Then to further explore any subjective cognitive complaints that Ben may have. It would be great to know if he is aware of his recent cognitive issues such as starting the car, leaving it running, and then taking the bus.
I would inquire about his work environment because he mentions trouble with his boss. If given informed consent I would speak to colleagues or supervisors at Ben’s workplace to gain insights into his recent behavior and performance. I would note any changes his co-workers may be able to provide as well. I would additionally obtain information about any recent changes or stressors at work.
It could be beneficial to dig more into his sleep patterns to assess any disturbances such as insomnia or hypersomnia. I would evaluate the impact of sleep disturbances on his daily functioning and relationships as well.
I would seek informed consent to speak to family members, work colleagues, and present and past medical professionals that may have saw him including mental health professionals.
I would refer Ben for a comprehensive neuropsychological evaluation to assess cognitive functioning and identify any potential neurocognitive disorders related to the head injury.
I would recommend individual psychotherapy, either with me or another mental health physician he feels comfortable with, to explore and address the underlying psychological factors contributing to his behavior changes.
It could be good to suggest marital or couples counseling to address any relationship issues between Ben and Cindy and provide support for both. This may be a stretch with his current mindset and or mood, but if he will agree and attend it may provide some help for his marriage to deal with the current situation and circumstance.
I would send bill for a more in depth psychiatric evaluation to assess the need for medication if mood or cognitive symptoms warrant pharmacological intervention, albeit perhaps premature at this early stage only after seeing him one time but perhaps a prescribing physician would know more of the psychopharmacological value that they can contribute than I do without formal training in the area.
Because Ben uses alcohol each day I would consider a comprehensive substance abuse assessment to determine the extent of the issue and appropriate interventions that may be necessary.
I would collaborate with as many professionals as necessary to provide the best care for Ben and to help resolve or help with his symptoms. Collaboration with a multidisciplinary team of professionals ensures a more comprehensive understanding of Ben’s situation and facilitates an integrated approach to his assessment and treatment. It is crucial to prioritize Ben’s well-being and the well-being of those in contact with him and tailor interventions to his and their specific needs. This proves to be a difficult case with such little information. There are many possibilities!

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