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Article

Trauma  

Nancy J. Smyth

This entry summarizes the current state of knowledge about the nature of trauma and intervention with trauma reactions. It includes the history of traumatology, demographics, theory, research and best practices, controversies, and current trends as well as diversity issues and international and interdisciplinary perspectives.

Article

This article presents information regarding the evolving understanding of the relationships between impulse-control disorders, compulsion-related disorders, and addictions (both substance-related and behavioral). The traditional model describing the relationship between impulse-control disorders and compulsion-related disorders is now considered overly simplistic. New research suggests that this relationship is complex, and distinctions between these disorders are not as solid as previously thought. Information about this dynamic relationship also has implications for substance use disorders and behavioral addictions.

Article

Susan Frauenholtz and Amy Mendenhall

Mental-health disorders are widely prevalent in children and adolescents, and social workers are the primary service providers for children and families experiencing these disorders. This entry provides an overview of some of the most commonly seen disorders in children and adolescents: attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, separation anxiety disorder, and specific learning disorders. The prevalence, course, diagnostic criteria, assessment guidelines, and treatment interventions are reviewed for each disorder. In addition, the key role of social workers in the identification and intervention of these disorders, as well as ways social workers can support the children and families experiencing these disorders, is discussed.

Article

Oren Shtayermman

This article reviews the changes in the autism spectrum disorder (ASD) diagnosis in the Diagnostic Statistical Manual (DSM)-5. It reviews the risk factors associated with suicide in the general population and the link between these risk factors and individuals on the autism spectrum. When discussing autism and suicide (as a spectrum), the complexities that the two present influence parents, researchers, and practitioners. As an added dimension of convolution, there are only a small number of published studies in the area of autism and suicide, and many have marked the importance of awareness and connection between autism and suicide. The article presents the most recent and available research on ASDs and suicide. Methodological challenges related to these studies will be discussed as well as the implications for research, practice, and education.

Article

Depression and bipolar mood disorders are mental disorders that are characterized by mood disturbance combined with decreased functioning of the affected individuals. This entry focuses on major depressive disorder and bipolar I and II disorders among adults in the United States. Bipolar disorder has unique clinical features and intervention options, and so it is discussed in a separate section after depression. Diagnosis, prevalence, comorbidity, risk factors, course, assessment, treatment, service utilization, and international perspectives are reviewed for each disorder. The implications for social work are briefly addressed at the end of this entry.

Article

Janet B. W. Williams and Michael First

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association is referred to as DSM-5 ™ . DSM-5’s early predecessor, DSM-III, differed considerably from the first two editions. Its innovative incorporation of specified diagnostic criteria had a major impact on the field of mental health. In DSM-5, these criteria have been further updated to reflect the important gains in our understanding of mental disorders.

Article

The historical development of the borderline concept is traced up through the development of the diagnosis of borderline personality disorder (BPD). Treatments for BPD during the 1970s and 1980s are discussed, including the object relations theories of Margaret Mahler and James Masterson, as well as trauma theory described by Judith Herman. Three evidence-based treatments (EBTs) that have emerged from the 1990s to the present time are described, as well as findings from brain imaging techniques and how new EBTs and neuroimaging have changed the view of this disorder.

Article

B. Michelle Brazeal and Gordon MacNeil

Obsessive compulsive disorder (OCD) is a debilitating anxiety problem. This article reviews the characteristics, etiology, prevalence, and assessment of OCD and presents information on the efficacy of psychological, pharmacological, and combined treatments for this disorder. Early intervention that includes pharmacological agents (typically SSRIs) as well as behavioral and cognitive-behavioral psychotherapies (particularly exposure and response prevention) is the preferred method of intervening with OCD.

Article

Michelle S. Ballan, Molly Burke Freyer, and Lauren Powledge

Evidence-based interventions for students with autism spectrum disorder (ASD) are explored, and trends and changes in the diagnosis of ASD in the United States are examined. Evidence-based interventions in various settings and modalities are discussed, with detailed descriptions of several effective evidence-based interventions including joint attention training, video modeling, story-based interventions, and activity schedules. The integral role of social workers in the lives of children with ASD in multiple settings, particularly the classroom, is emphasized. Social work must be vigilant to keep pace with the ever-changing field of autism, with its frequent improvements in understanding, diagnosis, and treatment.

Article

Traumatic events have permeated our lives throughout history and across the globe, inflicting profound losses on individuals, families, and communities during warfare, armed conflict, natural disasters, and relational violence. Although many survivors of these events harness their resilience and cope without long-term negative mental health effects, others experience a range of physical and mental health conditions, including trauma- and stress-related disorders. With an emphasis placed on adult trauma survivors, the conditions of posttraumatic stress disorder, acute stress disorder, adjustment disorders, complex trauma, and other stress-related conditions have been explored within a social context. Starting with a historical context, the following topics were addressed. The typologies of trauma were introduced including the definitions of Type I trauma—a single discrete event including natural catastrophes; Type II trauma—chronic and repetitive traumatic physical, sexual, and/or emotional abuse; and Type IIII—severe and multiple abusive events with multiple perpetrators. Historical and intergenerational trauma reflect a collective of complex traumatic events throughout generations that resonate in subsequent generations in terms of ungrieved losses and survivor guilt, among other psychosocial issues. Cultural and racial trauma include chronic verbal and/or physical assaults that involve racialized bigotry. Combat trauma involves a combination of deployment stressors that have affected servicemembers in distinct ways with “signature injuries” associated with different wartime conflicts. The next section addresses the current typology of the Diagnostic and Statistical Manual of Mental Disorders—V, noting the changes in diagnostic criteria, in particular related to the diagnosis of posttraumatic stress disorder (PTSD). Mental health responses to trauma vary a great deal based on a balance of risk and protective factors, often revealing noteworthy resilience and the absence of negative aftereffects. The neurobiological effects of trauma are addressed along with mental health conditions or disorders (e.g., acute stress response, PTSD, complex trauma, and anxiety disorders). Specific phase-oriented and multimodality treatment interventions are reviewed that focus specifically on the mental health conditions presented. These approaches are research-informed, culturally responsive, and theoretically grounded Finally, the responses experienced by clinicians who work with traumatized clients are outlined along with recommendations for ways to minimize the effects of secondary, or vicarious, traumatization. Clinical vignettes based on case composites have been utilized to illustrate central points.

Article

Clare S. Gaskins, Melissa A. Bitalvo, and Michele R. Cohen

There is growing evidence that obsessive-compulsive disorder (OCD) is much more common in children and adolescents than originally believed. While some youth with mild to moderate OCD may be able to navigate their school day with minimal interference, for others the disorder can cause significant impairment in the ability to concentrate on school work, complete homework, and make and maintain peer relationships. School social workers and staff can play a pivotal role in shaping learning environments that support students with OCD. This article provides an overview of clinical characteristics of OCD, its assessment and treatment, how children with the disorder may present in the school setting, and ways in which school staff can assist students with OCD.

Article

Rates of depression increase during adolescence and may put youth at risk for suicidality, future episodes, and impaired functioning in multiple life domains. Increased vulnerability for depression during this stage may occur because it is when the cognitive capacity for personal reflection, abstract reasoning, and formal operational thought develop; depressive styles for attributing events may hence form, along with hopelessness about the future. However, other biological and social influences may also interact with the increased cognitive vulnerability. Latino ethnicity and female gender appear to exert particular influence. Treatment for adolescent depression includes medication (mainly Prozac and Zoloft), cognitive-behavioral therapy, interpersonal therapy, and family therapy. Medication and psychosocial treatment is also combined, particularly for treatment-resistant depression.

Article

Concepcion Barrio, Mercedes Hernandez, Paula Helu Fernandez, and Judith A. DeBonis

Social workers in health and mental health and across public and private health sectors are expected to be knowledgeable of comprehensive approaches to effectively serve individuals dealing with psychotic disorders, including family members involved in their care. Effective services require expertise in assessment, diagnostics, treatment planning, and coordination of community support services. This article provides a knowledge base for social work practitioners working with clients challenged by the experience and consequences of serious mental illness, such as schizophrenia spectrum and other psychotic disorders. We begin by reviewing the public health significance of these disorders, clinical phenomenology and its historical context, and symptoms and classification. We then discuss the family and cultural context, evidence-based treatments, and several social and clinical issues that social work practitioners should be aware of when working with this client population.

Article

This entry focuses on services for adults with severe mental illness, specifically the five psychosocial interventions considered evidence-based practices. The emergence of psychiatric rehabilitation, the only professional discipline designed to serve a specified population, is described. The primary historical practice approaches, which are the foundation for psychiatric rehabilitation, are discussed. Each of the five evidence-based practices is then described with the empirical supporting evidence. The emphasis on this population and interventions were selected as social workers are the major providers for this population and frequent implementers and developers of these interventions.

Article

Elizabeth C. Pomeroy and Polly Y. Browning

Eating disorders involve maladaptive eating patterns accompanied by a wide range of physical complications likely to require extensive treatment. In addition, “eating disorders” frequently occur with other mental disorders, such as depression, substance abuse, and anxiety disorders. The earlier these disorders are diagnosed and treated, the better the chances are for full recovery” (NIMH, 2011). As of 2013, lifetime prevalence rates for anorexia nervosa, bulimia nervosa, and binge eating disorder are 0.9%, 1.5%, and 3.5% among females, and 0.3%, 0.5%, and 2.0% among males respectively (Hudson, Hiripi, Pope, & Kessler, 2007). Early diagnosis is imperative; the National Institute of Mental Health estimates that the mortality rate for anorexia is 0.56% per year, one of the highest mortality rates of any mental illness, including depression (NIMH, 2006). More recent research (Crow et al., 2009) indicates mortality rates as high as 4.0% for anorexia nervosa, 3.9% for bulimia nervosa and 5.2% for eating disorders not otherwise specified. Current research and treatment options are discussed.

Article

Lia Nower and Kyle Caler

Gambling disorder is a significant public health concern. The recent and continued proliferation of land-based and interactive gambling opportunities has increased both accessibility and acceptability of gambling in the United States and abroad, resulting in greater and more varied participation. However, there is currently no designated federal funding for prevention, intervention, treatment, or research, and states are left to adopt varying standards on an ad hoc basis. Social workers receive little or no training in screening or treating problem gamblers, though research suggests that a significant proportion of those with mental health and other addictive disorders also gamble excessively. Raising awareness about the nature and scope of gambling disorder and its devastating implications for families and children is a first-step toward integrating gambling into prevention, assessment and treatment education in social work. This, in turn, will increase the chances of early identification and intervention across settings and insure that social workers can lend a knowledgeable and credible voice to addressing this hidden addiction.

Article

Mansoo Yu and Rachel Fischer

Tobacco use is a major public-health concern in the United States. Intervention and prevention strategies for tobacco use are an urgent public-health priority because tobacco use is the single most preventable cause of death. To help social workers better understand tobacco use problems, this entry presents an overview, including definitions of terms, the scope and impact of tobacco use problems in terms of different segments of the population (that is, age, gender, race or ethnicity, geographic location, and education level or socioeconomic status), etiology of tobacco use (for example, biological or genetic; psychiatric; psychosocial; or environmental or sociocultural factors), policy history, tobacco prevention, clinical issues (such as cessation desire, treatment and success, or screening tools for tobacco use disorder and tobacco withdrawal), and practice interventions for tobacco use problems. Based on the information, the roles of social workers will be addressed.

Article

Diana M. DiNitto

This entry defines comorbidity and similar terms used in various fields of practice. It addresses the prevalence of comorbidity, suggests explanations for comorbidity, and discusses integrated treatment for comorbid conditions and the importance of the concept of comorbidity in social work practice.

Article

Selena T. Rodgers

Trauma literature has seen a paradigm shift from pathology to embracing positive trajectories. Posttraumatic growth (PTG), defined as a positive psychological change resulting from a struggle with traumatic or life-changing events, may occur in a variety of populations and events. This entry, therefore, aims to increase our understanding of PTG. The entry begins with the conceptualization of PTG, followed by a discussion of protective factor associations, measures, and psychometric priorities. Nuanced attention is given to global translations and cultural aspects. The entry then presents debates about the challenges, controversy, and biases, as well as an overview of the empirical literature. The entry concludes with PTG contributions for social-work practice and pedagogy, together with recommendations for future research.

Article

Sandy Magaña and Lauren Bishop

Autism spectrum disorder is a heritable, developmental disability that is characterized by challenges with social communication and the presence of restrictive and/or repetitive patterns of behavior. Autism spectrum disorder affects development and quality of life from very early development through old age. Social workers play a number of different roles in supporting and advocating for individuals on the autism spectrum and their families. It is important that social workers understand the etiology, diagnosis and treatment of autism spectrum disorder, how it manifests throughout the lifespan, and challenges faced by families affected by ASD.